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NPI Code Detail

MEDICARE: KAITLYN ELLENE OSBORN MS

MEDICARE: KAITLYN ELLENE OSBORN MS
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
1101YM0800XMental Health Counselor27773FL

General Provider Information

NPI Number : 1821789447
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN ELLENE OSBORN MS
Provider Business Mailing Address
First Line : 12321 TEAL RUN CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-3478
Country : US
Telephone Number : 904-206-2363
Fax Number :
Provider Business Practice Location Address
First Line : 5776 SAINT AUGUSTINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8046
Country : US
Telephone Number : 904-448-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2023
Last Update Date : 06/05/2026

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Directions to “ KAITLYN ELLENE OSBORN MS” Practice Location

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