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General NPI Number Information
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NPI Number | 1023491677
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Entity Type | Individual
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Provider Name | VERNON ANTHONY OSBORN PMHNP
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Gender | Male
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 610 N FIFTH ST
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City | GALLUP
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State | NM
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Zip | 87301-5306
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Country | US
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Telephone | 505-863-3120
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Fax | 505-443-8344
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Provider Business Mailing Address
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Address Line | HC 61 BOX 1028
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City | RAMAH
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State | NM
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Zip | 87321-9600
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP-02704
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-02704
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License Number State | NM
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