Provider Demographics
NPI:1780690388
Name:OZEE, MARY ANN (APN FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:OZEE
Suffix:
Gender:F
Credentials:APN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 RTE 45
Mailing Address - Street 2:BOX 250
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930
Mailing Address - Country:US
Mailing Address - Phone:618-273-7723
Mailing Address - Fax:618-273-3384
Practice Address - Street 1:1007 RTE 45
Practice Address - Street 2:BOX 250
Practice Address - City:ELDORADO
Practice Address - State:IL
Practice Address - Zip Code:62930
Practice Address - Country:US
Practice Address - Phone:618-273-7723
Practice Address - Fax:618-273-3384
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily