Healthcare Provider Details

I. General information

NPI: 1144569203
Provider Name (Legal Business Name): VERNON L OSBURN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 PENDLETON PIKE STE E
INDIANAPOLIS IN
46226-4888
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 317-561-3177
  • Fax: 877-961-4275
Mailing address:
  • Phone: 317-561-3177
  • Fax: 877-961-4275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71004358A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71004358A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28147623A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: