MEDICARE: NICHELLE OSBORNE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN-NP289892	GA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-NP289892	GA

General Provider Information

NPI Number	:	1184249815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHELLE OSBORNE NP

Provider Business Mailing Address
First Line	:	1870 THE EXCHANGE SE STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2171
Country	:	US
Telephone Number	:	404-913-6869
Fax Number	:

Provider Business Practice Location Address
First Line	:	1870 THE EXCHANGE SE STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2171
Country	:	US
Telephone Number	:	404-913-6869
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	12/11/2025

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