Provider Demographics
NPI:1194174870
Name:OSBORNE, DEBORAH
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TRUMAN RD
Mailing Address - Street 2:1000 TRUMAN RD.
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-3635
Mailing Address - Country:US
Mailing Address - Phone:757-232-6683
Mailing Address - Fax:
Practice Address - Street 1:1000 TRUMAN RD
Practice Address - Street 2:1000 TRUMAN RD.
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-3635
Practice Address - Country:US
Practice Address - Phone:757-232-6683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator