Individual
GLORY OSADIAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, MSN, BSN, RN
Contact information
Practice address
250 CONSTITUTION BLVD, LAWRENCEVILLE, GA 30046-8432
(470) 844-0157
(678) 539-8899
Mailing address
250 CONSTITUTION BLVD, LAWRENCEVILLE, GA 30046-8432
(470) 844-0157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN250999
GA
163WH0200X
Home Health Registered Nurse
RN250999
GA
163WH1000X
Hospice Registered Nurse
RN250999
GA
163WM0705X
Medical-Surgical Registered Nurse
RN250999
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN250999
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
250999
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN250999
GA
Other
Enumeration date
05/10/2021
Last updated
06/11/2023
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