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Individual

MRS. NICOLE L OSBORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, PA-C

Contact information

Practice address
4629 S REED AVE, SPRINGFIELD, MO 65804-6764
(000) 000-0000
Mailing address
4629 S REED AVE, SPRINGFIELD, MO 65804-6764

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2009003261
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
220024373
MO
Enumeration date
02/13/2009
Last updated
01/23/2026
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