Provider Demographics
NPI:1982860623
Name:OSBORNE, SARAH ELIZABETH JUMPER (PT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH JUMPER
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 HUCKLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-8998
Mailing Address - Country:US
Mailing Address - Phone:828-682-9742
Mailing Address - Fax:828-682-3762
Practice Address - Street 1:125 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3035
Practice Address - Country:US
Practice Address - Phone:828-682-9742
Practice Address - Fax:828-682-3762
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400011Medicaid
NCSOSBORNEMedicaid
NC3407100Medicaid