Healthcare Provider Details

I. General information

NPI: 1982583621
Provider Name (Legal Business Name): ADVIJE OSMANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 S MAIN ST
VIROQUA WI
54665-2059
US

IV. Provider business mailing address

W6343 SONNY DR APT 2
MENASHA WI
54952-9005
US

V. Phone/Fax

Practice location:
  • Phone: 920-691-6108
  • Fax:
Mailing address:
  • Phone: 920-691-6108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number150118-32
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: