Provider Demographics
NPI:1982592895
Name:OSBORNE, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GALLANT CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-9313
Mailing Address - Country:US
Mailing Address - Phone:757-322-0698
Mailing Address - Fax:239-294-3910
Practice Address - Street 1:115 GALLANT CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-9313
Practice Address - Country:US
Practice Address - Phone:757-322-0698
Practice Address - Fax:239-294-3910
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies