Individual
STEPHANIE A OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-0002
(217) 525-5643
(217) 544-3311
Mailing address
2 GOOD SAMARITAN WAY STE 205, MOUNT VERNON, IL 62864-2476
(618) 889-3869
(618) 899-3558
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209009395
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041351985
RN LIC
IL
01
—
209009395
STATE LIC
IL
Enumeration date
02/22/2012
Last updated
06/08/2021
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