Healthcare Provider Details

I. General information

NPI: 1497810311
Provider Name (Legal Business Name): NAOMI ELIZABETH DESHORE-OSBORNE RN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE, BLDG 9, 3RD FL, RM 3551
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE, BLDG 9, 3RD FL, RM 3551
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-1596
  • Fax:
Mailing address:
  • Phone: 301-400-1596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN54361
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberRN54361
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: