Provider Demographics
NPI:1962198267
Name:OSBORNE, SHAWN MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:MARIE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:MARIE
Other - Last Name:STEADMAN AND TOMKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1903 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6384
Mailing Address - Country:US
Mailing Address - Phone:989-415-5187
Mailing Address - Fax:
Practice Address - Street 1:946 W MIDLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9400
Practice Address - Country:US
Practice Address - Phone:989-266-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279564363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health