Provider Demographics
NPI:1679630362
Name:OSBORN, ALMA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:MARIE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N 2ND ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6130
Mailing Address - Country:US
Mailing Address - Phone:208-429-9100
Mailing Address - Fax:208-429-9118
Practice Address - Street 1:222 N 2ND ST STE 204
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6130
Practice Address - Country:US
Practice Address - Phone:208-429-9100
Practice Address - Fax:208-429-9118
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP2A163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDNPSE7OtherBLUE CROSS
ID000010151198OtherREGENCE BLUE SHIELD OF ID
IDMO0370558OtherDEA
ID000010151198OtherREGENCE BLUE SHIELD OF ID
IDNPSE7OtherBLUE CROSS