Provider Demographics
NPI:1316372048
Name:OSMAN, FOOS M (LPN)
Entity Type:Individual
Prefix:MS
First Name:FOOS
Middle Name:M
Last Name:OSMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4931
Mailing Address - Country:US
Mailing Address - Phone:602-764-7124
Mailing Address - Fax:602-764-7090
Practice Address - Street 1:4612 N 28TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4931
Practice Address - Country:US
Practice Address - Phone:602-764-7124
Practice Address - Fax:602-764-7090
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP046848164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse