Provider Demographics
NPI:1245513902
Name:OZUA, MARIA LUISA (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LUISA
Last Name:OZUA
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 1:205 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:TUTWILER
Mailing Address - State:MS
Mailing Address - Zip Code:38963-5067
Mailing Address - Country:US
Mailing Address - Phone:662-345-8334
Mailing Address - Fax:
Practice Address - Street 1:205 ALMA ST
Practice Address - Street 2:
Practice Address - City:TUTWILER
Practice Address - State:MS
Practice Address - Zip Code:38963-5067
Practice Address - Country:US
Practice Address - Phone:662-345-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily