GLORY OSADIAYE PMHNP MSN BSN RN NPI 1003490764

NPI Information

NPI: 1003490764
Provider Name: GLORY OSADIAYE, PMHNP, MSN, BSN, RN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
250 CONSTITUTION BLVD
LAWRENCEVILLE, GA
ZIP 30046
Phone: (470) 844-0157
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Glory Osadiaye, PMHNP, MSN, BSN, RN is a psychiatric/mental health nurse practitioner in Lawrenceville, GA with 3 years of experience. Glory Osadiaye, PMHNP, MSN, BSN, RN NPI is 1003490764. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

250 CONSTITUTION BLVD
LAWRENCEVILLE, GA
ZIP 30046-432
Phone: (470) 844-0157
Fax: (678) 539-8899

The NPI 1003490764 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/10/2021 and was last updated on 6/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN250999	GEORGIA	No
2	163WH0200X	Registered Nurse	Home Health	RN250999	GEORGIA	No
3	163WH1000X	Registered Nurse	Hospice	RN250999	GEORGIA	No
4	163WM0705X	Registered Nurse	Medical-Surgical	RN250999	GEORGIA	No
5	163WP0808X	Registered Nurse	Psychiatric/Mental Health	RN250999	GEORGIA	No
6	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	RN250999	GEORGIA	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	250999	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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