Healthcare Provider Details

I. General information

NPI: 1033951389
Provider Name (Legal Business Name): MARY MARGARET SCHLOSSER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10055 FORD AVE
RICHMOND HILL GA
31324-3972
US

IV. Provider business mailing address

10055 FORD AVE
RICHMOND HILL GA
31324-3972
US

V. Phone/Fax

Practice location:
  • Phone: 912-623-4756
  • Fax: 912-457-7480
Mailing address:
  • Phone: 912-623-4756
  • Fax: 912-457-7480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberRN279389
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11034253
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN279389
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: