Provider Demographics
NPI:1033645403
Name:OSBORNE, COURTNEY (HM)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:HM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS ABRAHAM LINCOLN CVN 72
Mailing Address - Street 2:MEDICAL DEPARTMENT
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09520
Mailing Address - Country:US
Mailing Address - Phone:757-534-0097
Mailing Address - Fax:
Practice Address - Street 1:USS ABRAHAM LINCOLN CVN 72
Practice Address - Street 2:MEDICAL DEPARTMENT
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:09520
Practice Address - Country:US
Practice Address - Phone:757-534-0097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman