Healthcare Provider Details

I. General information

NPI: 1790627925
Provider Name (Legal Business Name): DANIEL WAYNE OSBORNE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 13TH ST S APT 16
GREAT FALLS MT
59405-4543
US

IV. Provider business mailing address

215 1ST AVE N GENERAL DELIVERY
GREAT FALLS MT
59401-2553
US

V. Phone/Fax

Practice location:
  • Phone: 406-607-0479
  • Fax:
Mailing address:
  • Phone: 406-607-0479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: