Provider Demographics
NPI:1427039361
Name:OSBORNE, MARILYN RUTH (CNM, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:RUTH
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:CNM, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:501 PEBBLE CREEK DR
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749-0585
Mailing Address - Country:US
Mailing Address - Phone:606-672-1243
Mailing Address - Fax:606-672-4231
Practice Address - Street 1:441 GORMAN HOLLOW RD
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-2315
Practice Address - Country:US
Practice Address - Phone:606-439-2361
Practice Address - Fax:606-439-0870
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1023P363LF0000X
KY1023M367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYS53523Medicare UPIN
KY0281407Medicare PIN
KY0281807Medicare PIN
KY0059626Medicare PIN
KY0281507Medicare PIN
KY0281706Medicare PIN
KY0281906Medicare PIN
KY0281606Medicare PIN