Healthcare Provider Details

I. General information

NPI: 1134915796
Provider Name (Legal Business Name): KATHERINE LYNNETTE OSBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 OFFICE PLAZA DR N STE 105
WEST DES MOINES IA
50266-2339
US

IV. Provider business mailing address

336 HART AVE
DES MOINES IA
50315-5271
US

V. Phone/Fax

Practice location:
  • Phone: 319-559-7744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: