Provider Demographics
NPI:1801663752
Name:OSBORNE, JACOB CHRISTOPHER (FNP)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:CHRISTOPHER
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15326 ALBERT WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-8429
Mailing Address - Country:US
Mailing Address - Phone:661-378-4432
Mailing Address - Fax:
Practice Address - Street 1:9802 STOCKDALE HWY STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3653
Practice Address - Country:US
Practice Address - Phone:661-665-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027962363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner