Individual
LISA YVETTE OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
3080 COX RD, SUMTER, SC 29154-9494
(803) 481-5791
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
AG07180119
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
AG07180119
SD
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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