Provider Demographics
NPI:1972162337
Name:OSTASZEWSKI, KARLA (FNP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:OSTASZEWSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48153 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4906
Mailing Address - Country:US
Mailing Address - Phone:586-243-4181
Mailing Address - Fax:
Practice Address - Street 1:48153 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4906
Practice Address - Country:US
Practice Address - Phone:586-243-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704230199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily