Provider Demographics
NPI:1518233345
Name:JESSICA OSBORN MD PLLC
Entity Type:Organization
Organization Name:JESSICA OSBORN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-296-0670
Mailing Address - Street 1:1120 19TH ST NW
Mailing Address - Street 2:200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3605
Mailing Address - Country:US
Mailing Address - Phone:202-296-0670
Mailing Address - Fax:202-331-8924
Practice Address - Street 1:1120 19TH ST NW
Practice Address - Street 2:200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3605
Practice Address - Country:US
Practice Address - Phone:202-296-0670
Practice Address - Fax:202-331-8924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care