Provider Demographics
NPI:1144213737
Name:OSGOOD, JEAN MARIE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:MARIE
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18803 270TH ST
Mailing Address - Street 2:
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-8637
Mailing Address - Country:US
Mailing Address - Phone:641-366-2520
Mailing Address - Fax:
Practice Address - Street 1:405 6TH ST
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-1529
Practice Address - Country:US
Practice Address - Phone:319-825-4441
Practice Address - Fax:319-825-4440
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-065705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0422501Medicaid
IAI-8980Medicare ID - Type Unspecified
IA0422501Medicaid