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General NPI Number Information
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NPI Number | 1437961778
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Entity Type | Organization
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Legal Business Name | TRACEY OSBORNE PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 1100 NEW YORK AVE STE B
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6924
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Country | US
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Telephone | 575-488-3248
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Fax | 575-488-3249
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Provider Business Mailing Address
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Address Line | PO BOX 543
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City | LA LUZ
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State | NM
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Zip | 88337-0543
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Country | US
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Telephone | 575-488-3248
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Fax | 575-488-3249
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Authorized Official
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Title or Position | CNP/OWNER
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Name | TRACEY MARIE OSBORNE
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Credential | CNP
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Telephone | 505-400-0488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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