Provider Demographics
NPI:1225129406
Name:STOSIC, MARY JEAN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JEAN
Last Name:STOSIC
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 MARK TWAIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2710
Mailing Address - Country:US
Mailing Address - Phone:412-688-6952
Mailing Address - Fax:412-688-6588
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:VA PITTSBURGH HEALTHCARE SYSTEM
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1001
Practice Address - Country:US
Practice Address - Phone:412-688-6952
Practice Address - Fax:412-688-6588
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005125B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily