Individual
PENNY J OGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
950 MEDICAL DR, BRIGHAM CITY, UT 84302-4724
(800) 594-6399
(801) 733-5618
Mailing address
1954 FORT UNION BLVD, SALT LAKE CITY, UT 84121-6800
(801) 993-9500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
225108-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001918101
IHC
UT
01
—
2080245
UHC
UT
01
—
340896
DMBA
UT
01
—
47568
PEHP
UT
01
—
87040324684121 A004
TRICARE
UT
01
—
870576522OG1
EDUCATOR'S
UT
01
—
PRA04451
MOLINA
UT
01
—
QM0000076538
ALTIUS
UT
Enumeration date
07/21/2006
Last updated
07/08/2007
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