Individual
KELAN LANE OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 HOSPITAL DR STE 102, OSAGE BEACH, MO 65065-3050
(573) 348-8000
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021038522
MO
363A00000X
Physician Assistant
PA2441
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220112004
—
MO
Enumeration date
11/17/2014
Last updated
08/08/2023
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