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General NPI Number Information
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NPI Number | 1003013236
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Entity Type | Individual
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Provider Name | MARY EVA OSTASZEWSKI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 4720 NELSON BROGDON BLVD
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City | SUGAR HILL
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State | GA
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Zip | 30518-3480
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Country | US
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Telephone | 770-945-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 NELSON BROGDON BLVD
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City | BUFORD
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State | GA
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Zip | 30518-3480
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Country | US
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Telephone | 770-945-1990
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Fax | 770-945-3631
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN144234
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN 144234
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License Number State | GA
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