Healthcare Provider Details

I. General information

NPI: 1679404081
Provider Name (Legal Business Name): ELIZABETH L OSSWALD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MARKET ST
TROY OH
45373-1418
US

IV. Provider business mailing address

533 W. WESTBROOK RD
BROOKVILLE OH
45309
US

V. Phone/Fax

Practice location:
  • Phone: 937-332-6700
  • Fax:
Mailing address:
  • Phone: 937-903-8283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.155888.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: