Basic Information
| Provider Information | |||||||||
| NPI: | 1558356501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSBORN | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 ATCHISON ST | ||||||||
| Address2: | |||||||||
| City: | OSKALOOSA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660665041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7855953450 | ||||||||
| FaxNumber: | 7855953493 | ||||||||
| Practice Location | |||||||||
| Address1: | 3313B THRASHER RD | ||||||||
| Address2: | |||||||||
| City: | WHITE CLOUD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660944028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7855953450 | ||||||||
| FaxNumber: | 7855953493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 1-12656 | KS | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.