Individual
MS. JACQUELINE LATRESE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4041 BRUMBAUGH BOULEVARD, DAYTON, OH 45416
(937) 608-6396
Mailing address
4041 BRUMBAUGH BLVD, DAYTON, OH 45416-1610
(937) 608-6396
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
132618
OH
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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