Individual
LISA OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(417) 533-6100
(417) 533-6021
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
109636
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811092281
—
MO
01
—
431560263
TRICARE
MO
Enumeration date
09/13/2006
Last updated
02/09/2012
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