Provider Demographics
NPI:1720839368
Name:OSBORN, ANNA KATE (OD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:KATE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E BROOKLYN VILLAGE AVE UNIT 437
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3611
Mailing Address - Country:US
Mailing Address - Phone:217-454-6884
Mailing Address - Fax:
Practice Address - Street 1:8316 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-6702
Practice Address - Country:US
Practice Address - Phone:704-547-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2826152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist