Basic Information
| Provider Information | |||||||||
| NPI: | 1841722139 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSAGIE | ||||||||
| FirstName: | OSAHANOR | ||||||||
| MiddleName: | VANESSA | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 CALVERT ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105283131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148350073 | ||||||||
| FaxNumber: | 9148351071 | ||||||||
| Practice Location | |||||||||
| Address1: | 8307 KNIGHT RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137969955 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2017 | ||||||||
| LastUpdateDate: | 07/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | F0117137 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.