Basic Information
| Provider Information | |||||||||
| NPI: | 1578044434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSBORNE | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 245 NEAL AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT GILEAD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433389372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199466734 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 88 N SANDUSKY ST | ||||||||
| Address2: | |||||||||
| City: | DELAWARE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430151756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402033800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2018 | ||||||||
| LastUpdateDate: | 04/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WA0400X | RN.406360 | OH | Y | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No ID Information.