Provider Demographics
NPI:1386042349
Name:OSBORNE, LINDSAY
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2019 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9678
Mailing Address - Country:US
Mailing Address - Phone:740-385-8517
Mailing Address - Fax:
Practice Address - Street 1:2019 E FRONT ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9678
Practice Address - Country:US
Practice Address - Phone:740-385-8517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3933877171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator