Provider Demographics
NPI:1235513193
Name:OSBORNE, NANCY GAYLE (RN, NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:GAYLE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E 85TH ST
Mailing Address - Street 2:APT 2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6374
Mailing Address - Country:US
Mailing Address - Phone:415-308-2047
Mailing Address - Fax:
Practice Address - Street 1:413 E 85TH ST
Practice Address - Street 2:APT 2F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6374
Practice Address - Country:US
Practice Address - Phone:415-308-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677496163W00000X
NY382667363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse