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Individual

LISA R OSBORNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
3650 DALEFORD RD., SHAKER HEIGHTS, OH 44120
(216) 921-2476
Mailing address
3650 DALEFORD RD, SHAKER HEIGHTS, OH 44120-5255
(216) 921-2476

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
2734778
OH
376K00000X
Nurse's Aide
Primary
400214630203
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2734778
OH
Enumeration date
04/24/2008
Last updated
04/24/2008
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