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General NPI Number Information
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NPI Number | 1255507950
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Entity Type | Individual
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Provider Name | MARILYN JOYCE OSTENDORF N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 123 N MCCREARY ST
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City | FORT BRANCH
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State | IN
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Zip | 47648-1313
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Country | US
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Telephone | 812-753-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 8755 GLENNBROOKE DR
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City | NEWBURGH
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State | IN
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Zip | 47630-3712
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Country | US
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Telephone | 812-925-3302
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71002503A
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License Number State | IN
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