Provider Demographics
NPI:1558356501
Name:OSBORN, AMY L (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:OSBORN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ATCHISON ST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:KS
Mailing Address - Zip Code:66066-5041
Mailing Address - Country:US
Mailing Address - Phone:785-595-3450
Mailing Address - Fax:785-595-3493
Practice Address - Street 1:3313B THRASHER RD
Practice Address - Street 2:
Practice Address - City:WHITE CLOUD
Practice Address - State:KS
Practice Address - Zip Code:66094-4028
Practice Address - Country:US
Practice Address - Phone:785-595-3450
Practice Address - Fax:785-595-3493
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist