Provider Demographics
NPI:1164092045
Name:OSMUS, MEAGAN PAIGE
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:PAIGE
Last Name:OSMUS
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 1:20 S BRYANT AVE APT 231
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6318
Mailing Address - Country:US
Mailing Address - Phone:158-082-2029
Mailing Address - Fax:
Practice Address - Street 1:20 S BRYANT AVE APT 231
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6318
Practice Address - Country:US
Practice Address - Phone:580-822-0296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator