Provider Demographics
NPI:1245601962
Name:OSTOS, ANITRA (RN)
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:
Last Name:OSTOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GUFFEY ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551
Mailing Address - Country:US
Mailing Address - Phone:931-243-2651
Mailing Address - Fax:
Practice Address - Street 1:115 GUFFEY ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551
Practice Address - Country:US
Practice Address - Phone:931-243-2651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1137191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse