Provider Demographics
NPI:1770594657
Name:OSBORNE, LINDA LEE (MSN RN PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MSN RN PMHNP-BC
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Mailing Address - Street 1:2886 SHOREWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3128
Mailing Address - Country:US
Mailing Address - Phone:810-357-1103
Mailing Address - Fax:
Practice Address - Street 1:441 S LIVERNOIS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2584
Practice Address - Country:US
Practice Address - Phone:248-608-8800
Practice Address - Fax:248-608-2490
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2014-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704164713163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5008606200OtherBLUE CROSS BLUE SHIELD
MI5008606200OtherBLUE CROSS BLUE SHIELD