Provider Demographics
NPI:1194988303
Name:OSBORNE, KAREN JEAN (RD)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JEAN
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-0377
Mailing Address - Country:US
Mailing Address - Phone:606-473-9838
Mailing Address - Fax:606-473-6405
Practice Address - Street 1:806 SEATON AVE
Practice Address - Street 2:SUITE1
Practice Address - City:GREENUP
Practice Address - State:KY
Practice Address - Zip Code:41144-1196
Practice Address - Country:US
Practice Address - Phone:606-473-9838
Practice Address - Fax:606-473-6405
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
712003133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0274004Medicare PIN