Individual
LISA OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5734 COVENTRY LN, FORT WAYNE, IN 46804-7141
(260) 436-7875
Mailing address
5734 COVENTRY LN, FORT WAYNE, IN 46804-7141
(260) 436-7875
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28176743A
IN
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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