Provider Demographics
NPI:1427700657
Name:OSTERLOH, BRENDA LYNN (RN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LYNN
Last Name:OSTERLOH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 MCFEELEY PETRY RD
Mailing Address - Street 2:
Mailing Address - City:ROSSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45362-9747
Mailing Address - Country:US
Mailing Address - Phone:419-540-0764
Mailing Address - Fax:
Practice Address - Street 1:3690 MCFEELEY PETRY RD
Practice Address - Street 2:
Practice Address - City:ROSSBURG
Practice Address - State:OH
Practice Address - Zip Code:45362-9747
Practice Address - Country:US
Practice Address - Phone:419-540-0764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-259363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse