Basic Information
Provider Information
NPI: 1528103157
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSBORNE
FirstName: JULIA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 138 LEADER AVE
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405083215
CountryCode: US
TelephoneNumber: 8592577910
FaxNumber: 8592577899
Practice Location
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 02/21/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X4136PKYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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