Provider Demographics
NPI:1780291054
Name:OSBORNE, MARIANNE S
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:S
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 1:1121 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-6449
Mailing Address - Country:US
Mailing Address - Phone:403-529-0837
Mailing Address - Fax:
Practice Address - Street 1:1121 SUNSET ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-6449
Practice Address - Country:US
Practice Address - Phone:740-352-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care