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General NPI Number Information
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NPI Number | 1558140475
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Entity Type | Individual
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Provider Name | TONYA COLLEEN OSBORN PRSS
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Gender | Female
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2887 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89109-1511
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Country | US
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Telephone | 702-747-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 3985 E CHEYENNE AVE APT 262
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City | LAS VEGAS
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State | NV
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Zip | 89115-7448
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Country | US
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Telephone | 720-649-7404
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | CAPRC2-5172
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | PRSS-5195
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License Number State | NV
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