Provider Demographics
NPI:1548265929
Name:OSBRON, DONNA (APRN, WHNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OSBRON
Suffix:
Gender:F
Credentials:APRN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-415-7653
Mailing Address - Fax:270-575-8359
Practice Address - Street 1:2605 KENTUCKY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3800
Practice Address - Country:US
Practice Address - Phone:270-443-1220
Practice Address - Fax:270-443-0023
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003632363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78007861Medicaid
KY78007861Medicaid
KYP63920Medicare UPIN