Healthcare Provider Details

I. General information

NPI: 1104148923
Provider Name (Legal Business Name): OSNA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2010
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10250 N 92ND ST SUITE 308
SCOTTSDALE AZ
85258-4510
US

IV. Provider business mailing address

PO BOX 271429
SALT LAKE CITY UT
84127-1429
US

V. Phone/Fax

Practice location:
  • Phone: 480-947-3700
  • Fax: 480-941-1640
Mailing address:
  • Phone: 602-772-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA A ENGLERT
Title or Position: CREDENTIALING AUTHORITY
Credential:
Phone: 602-385-2115