MEDICARE: AGNIESZKA OSAK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	508016	OH

General Provider Information

NPI Number	:	1174206825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNIESZKA OSAK

Provider Business Mailing Address
First Line	:	1244 ANDERSON FERRY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4224
Country	:	US
Telephone Number	:	773-552-6310
Fax Number	:

Provider Business Practice Location Address
First Line	:	1244 ANDERSON FERRY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4224
Country	:	US
Telephone Number	:	773-552-6310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	08/09/2023

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Directions to “ AGNIESZKA OSAK ” Practice Location

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