Provider Demographics
NPI:1316163306
Name:OSBORN, MEGAN JOANNA (NP PMHNP ANP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOANNA
Last Name:OSBORN
Suffix:
Gender:F
Credentials:NP PMHNP ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2719
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97308-2719
Mailing Address - Country:US
Mailing Address - Phone:503-399-8200
Mailing Address - Fax:503-363-2600
Practice Address - Street 1:1505 WATER ST NE
Practice Address - Street 2:SUITE 2
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-399-8200
Practice Address - Fax:503-363-2600
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR081000718N3363L00000X
OR363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner