Provider Demographics
NPI:1801319421
Name:OSGOOD, JULIE ANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 N 16TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3241
Mailing Address - Country:US
Mailing Address - Phone:928-899-6536
Mailing Address - Fax:
Practice Address - Street 1:5320 N 16TH ST STE 107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3241
Practice Address - Country:US
Practice Address - Phone:928-899-6536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP10402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily