Provider Demographics
NPI:1306204441
Name:OSSERMAN, JANICE (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:OSSERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:NY
Mailing Address - Zip Code:13165-1006
Mailing Address - Country:US
Mailing Address - Phone:315-729-0793
Mailing Address - Fax:315-789-9018
Practice Address - Street 1:39 N SENECA ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NY
Practice Address - Zip Code:13165-1006
Practice Address - Country:US
Practice Address - Phone:315-729-0793
Practice Address - Fax:315-789-9018
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY500900163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health