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Individual
MEREDITH ELISE OSBORNE
Active
Individual
MEREDITH ELISE OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
04731
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110010413
PA LICENSE
VA
01
—
PA-04731
PA LICENSE
SC
01
—
TPPA797
PA LICENSE
FL
Enumeration date
09/13/2019
Last updated
10/21/2024
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