Healthcare Provider Details

I. General information

NPI: 1821494352
Provider Name (Legal Business Name): MARY OPARA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2014
Last Update Date: 02/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 LAWRENCEVILLE SUWANEE ROAD SUITE 747
SUWANEE GA
30024
US

IV. Provider business mailing address

2090 LAWRENCEVILLE SUWANEE ROAD SUITE 747
SUWANEE GA
30024
US

V. Phone/Fax

Practice location:
  • Phone: 678-974-0342
  • Fax: 770-436-7143
Mailing address:
  • Phone: 770-431-2354
  • Fax: 770-436-7143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN145961
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: