Provider Demographics
NPI:1548553944
Name:OSBORNE, DAVID H
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 WEST DOUGLAS
Mailing Address - Street 2:BOX 246
Mailing Address - City:O'NEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-0246
Mailing Address - Country:US
Mailing Address - Phone:402-336-2800
Mailing Address - Fax:402-336-2849
Practice Address - Street 1:405 W DOUGLAS ST
Practice Address - Street 2:BOX 246
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1719
Practice Address - Country:US
Practice Address - Phone:402-336-2800
Practice Address - Fax:402-336-2849
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator