Provider Demographics
NPI:1922662501
Name:OUZA, AYAA ABBAS (FNP-C)
Entity Type:Individual
Prefix:
First Name:AYAA
Middle Name:ABBAS
Last Name:OUZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 SOUTHFIELD FWY
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-4030
Mailing Address - Country:US
Mailing Address - Phone:734-846-6505
Mailing Address - Fax:
Practice Address - Street 1:3120 CARPENTER ST STE 201
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2771
Practice Address - Country:US
Practice Address - Phone:313-369-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704316972NSA190AT363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty