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Individual
MARY LOUISE E OSEVALA
Active
Individual
MARY LOUISE E OSEVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP009932
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103243800
—
PA
01
—
SP009932
MEDICAL LICENSE
PA
Enumeration date
05/03/2006
Last updated
05/25/2017
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