Healthcare Provider Details

I. General information

NPI: 1750156543
Provider Name (Legal Business Name): RACHEL ANNE OSBORNE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LIVEWELL DR
KENNEBUNK ME
04043-6762
US

IV. Provider business mailing address

32 FIELDSTONE LN
SANFORD ME
04073-5055
US

V. Phone/Fax

Practice location:
  • Phone: 207-467-8988
  • Fax: 207-467-8969
Mailing address:
  • Phone: 207-459-4622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP231551
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: