Individual
STACEY NICOLE OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH,PHDH
Contact information
Practice address
225 RICHMOND AVE E STE B, MATTOON, IL 61938-4651
(217) 235-0800
(217) 235-0801
Mailing address
225 RICHMOND AVE E STE B, MATTOON, IL 61938-4651
(217) 235-0800
(217) 235-0801
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020015325
IL
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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