Organization
PEDIATRIC AND NEONATAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA OSBORNE MD (OWNER/PRESIDENT)
(502) 777-2903
Entity
Organization
Contact information
Practice address
4123 DUTCHMANS LN STE 410, LOUISVILLE, KY 40207-4733
(502) 893-5502
(502) 969-8378
Mailing address
4123 DUTCHMANS LN STE 410, LOUISVILLE, KY 40207-4733
(502) 893-5502
(502) 969-8378
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
50935
KY
363A00000X
Physician Assistant
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049802
PASSPORT
KY
01
—
1049803
PASSPORT
KY
01
—
1049804
PASSPORT
KY
01
—
1049810
PASSPORT
KY
01
—
1049812
PASSPORT
KY
01
—
1049813
PASSPORT
KY
01
—
1072557
PASSPORT
KY
01
—
1072558
PASSPORT
KY
01
—
1072559
PASSPORT
KY
01
—
1104973
PASSPORT
KY
01
—
1104978
PASSPORT
KY
01
—
3433
ANTHEM
KY
05
—
64170442
—
KY
05
—
64175110
—
KY
05
—
64180623
—
KY
05
—
64327810
—
KY
05
—
65922296
—
KY
Enumeration date
02/16/2007
Last updated
03/24/2026
Update your record
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