Provider Demographics
NPI:1699747527
Name:OSBORNE, HEATHER CHRISTINE (CNM)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 MIDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1403
Mailing Address - Country:US
Mailing Address - Phone:718-953-7787
Mailing Address - Fax:718-567-0737
Practice Address - Street 1:630 59TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3909
Practice Address - Country:US
Practice Address - Phone:718-567-0730
Practice Address - Fax:718-567-0737
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000878-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife