Provider Demographics
NPI:1841514486
Name:OSBORNE, SHERRI W (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:W
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:LYNN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4417 SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-7021
Mailing Address - Country:US
Mailing Address - Phone:910-275-4605
Mailing Address - Fax:844-835-3565
Practice Address - Street 1:4417 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-7021
Practice Address - Country:US
Practice Address - Phone:910-275-4605
Practice Address - Fax:844-835-3565
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004701363L00000X, 363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113098Medicaid
NC6113098Medicaid
NC2594759AMedicare PIN