Provider Demographics
NPI:1396076485
Name:OSBORNE, YOLONDA YVETTE (LVN)
Entity type:Individual
Prefix:MRS
First Name:YOLONDA
Middle Name:YVETTE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 N FARWELL AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1581
Mailing Address - Country:US
Mailing Address - Phone:414-736-0041
Mailing Address - Fax:
Practice Address - Street 1:1936 N FARWELL AVE
Practice Address - Street 2:APT 3
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1581
Practice Address - Country:US
Practice Address - Phone:414-736-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32757-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse