Provider Demographics
NPI:1881860336
Name:OSBORN, AMY JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JEAN
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:JEAN
Other - Last Name:STROSCHEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 S MAPLE ST
Mailing Address - Street 2:RIDGEVIEW MEDICAL CENTER
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1752
Mailing Address - Country:US
Mailing Address - Phone:952-442-2191
Mailing Address - Fax:952-442-6539
Practice Address - Street 1:500 S MAPLE ST
Practice Address - Street 2:RIDGEVIEW MEDICAL CENTER
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1752
Practice Address - Country:US
Practice Address - Phone:952-442-2191
Practice Address - Fax:952-442-6539
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN52320207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN18843OtherRESIDENT PERMIT