Provider Demographics
NPI:1154712701
Name:OSBORNE, SANDRA E (PMHNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 TAOS RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-1232
Mailing Address - Country:US
Mailing Address - Phone:719-423-1500
Mailing Address - Fax:719-423-1800
Practice Address - Street 1:1591 TAOS RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81006-1232
Practice Address - Country:US
Practice Address - Phone:719-423-1500
Practice Address - Fax:719-423-1800
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998660-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health