Healthcare Provider Details

I. General information

NPI: 1508740838
Provider Name (Legal Business Name): JULIA ELIZABETH OSBORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4848 GATEWAY BLVD
MAPLE PLAIN MN
55359-4405
US

IV. Provider business mailing address

13000 44TH AVE N
MINNEAPOLIS MN
55442-2607
US

V. Phone/Fax

Practice location:
  • Phone: 763-292-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14028
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: