Provider Demographics
NPI:1154071363
Name:COBB-OSBORNE, CHRISTINE JANELL (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JANELL
Last Name:COBB-OSBORNE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISITNE
Other - Middle Name:JANELL
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1291 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6168
Mailing Address - Country:US
Mailing Address - Phone:813-653-1880
Mailing Address - Fax:813-654-2778
Practice Address - Street 1:1291 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6168
Practice Address - Country:US
Practice Address - Phone:813-653-1880
Practice Address - Fax:813-654-2778
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017583363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117771100Medicaid