Healthcare Provider Details

I. General information

NPI: 1497793608
Provider Name (Legal Business Name): CARRIE M. OSIIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE M. WINTER

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3071 S GRAND AVE
CARTHAGE MO
64836-7851
US

IV. Provider business mailing address

3116 MEDICAL PARK DR
CARTHAGE MO
64836-1211
US

V. Phone/Fax

Practice location:
  • Phone: 417-358-4811
  • Fax: 330-408-0009
Mailing address:
  • Phone: 417-358-4811
  • Fax: 330-408-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2002018693
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number46165
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-46165-091
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: