Individual
CANDICE OGLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APN,C
Contact information
Practice address
2475 MCCLELLAN AVE, PENNSAUKEN, NJ 08109-4683
(856) 675-3660
(856) 675-3659
Mailing address
2475 MCCLELLAN AVE, LIFE AT LOURDES, PENNSAUKEN, NJ 08109
(856) 675-3660
(856) 675-3659
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00039200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029475
—
NJ
Enumeration date
05/01/2006
Last updated
03/15/2012
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