Provider Demographics
NPI:1033726708
Name:OSBORNE, DEBRA KAY
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:KAY
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9771
Mailing Address - Country:US
Mailing Address - Phone:740-443-6034
Mailing Address - Fax:
Practice Address - Street 1:407 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9771
Practice Address - Country:US
Practice Address - Phone:740-443-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151840Medicaid
OH6601467OtherDODD CONTRACT NUMBER