Healthcare Provider Details

I. General information

NPI: 1932748480
Provider Name (Legal Business Name): TIFFANY OSBORNE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 ASHBY STATE RD
FITCHBURG MA
01420-2038
US

IV. Provider business mailing address

47 ASHBY STATE RD
FITCHBURG MA
01420-2038
US

V. Phone/Fax

Practice location:
  • Phone: 351-220-2716
  • Fax: 253-367-8879
Mailing address:
  • Phone: 351-220-2716
  • Fax: 253-367-8879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2287109
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: