Individual
MARY LOUISE E OSEVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1000 N FRONT ST, WORMLEYSBURG, PA 17043-1034
(717) 731-0101
(717) 731-8359
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
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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