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Individual

TAMMY L OSBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
702 W CHESTNUT ST, BLOOMINGTON, IL 61701-2814
(309) 557-1400
Mailing address
448 WYLIE DR STE L100, NORMAL, IL 61761-5405
(888) 924-3786

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041315198
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.030221
IL

Other

Enumeration date
04/20/2006
Last updated
08/21/2024
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