Provider Demographics
NPI:1982999454
Name:OSBORNE, KATRINA NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:NICOLE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 CONSTANT FRIENDSHIP BLVD
Mailing Address - Street 2:T-1871
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2566
Mailing Address - Country:US
Mailing Address - Phone:410-670-9001
Mailing Address - Fax:410-670-9001
Practice Address - Street 1:403 CONSTANT FRIENDSHIP BLVD
Practice Address - Street 2:T-1871
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-2566
Practice Address - Country:US
Practice Address - Phone:410-670-9001
Practice Address - Fax:410-670-9001
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist