Provider Demographics
NPI:1124075965
Name:OSGOOD, TORI GAIL (NP)
Entity type:Individual
Prefix:MRS
First Name:TORI
Middle Name:GAIL
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:TORI
Other - Middle Name:GAIL
Other - Last Name:CHARRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:111 S MONROE ST
Mailing Address - Street 2:UNIT 105A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3007
Mailing Address - Country:US
Mailing Address - Phone:303-316-2713
Mailing Address - Fax:303-316-2713
Practice Address - Street 1:950 BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2706
Practice Address - Country:US
Practice Address - Phone:303-813-7698
Practice Address - Fax:303-813-7673
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO167765363LW0102X
TX671978363LW0102X
WY22463.342363LW0102X
NMR54482363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41888545Medicaid