Provider Demographics
NPI:1538638291
Name:OSBORNE, TRISHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 LAUREL CYN
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4726
Mailing Address - Country:US
Mailing Address - Phone:276-356-9116
Mailing Address - Fax:
Practice Address - Street 1:2790 E STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5849
Practice Address - Country:US
Practice Address - Phone:423-288-9286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214658183500000X
TN0000039500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist