Provider Demographics
NPI:1215153341
Name:OSBURN, ANN FRANCES
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:FRANCES
Last Name:OSBURN
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 1:3259 FANONE DR
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-7255
Mailing Address - Country:US
Mailing Address - Phone:810-966-8437
Mailing Address - Fax:810-966-8437
Practice Address - Street 1:2910 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-1976
Practice Address - Country:US
Practice Address - Phone:810-987-3663
Practice Address - Fax:810-987-1411
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist