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General NPI Number Information
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NPI Number | 1821412396
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Entity Type | Individual
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Provider Name | BETSY MCCULLOCH OSBORN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 600 WHITESPORT CIR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6495
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Country | US
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Telephone | 256-429-5622
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Fax | 256-429-4618
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Provider Business Mailing Address
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Address Line | 3007 MEMORIAL PKWY SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5393
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Country | US
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Telephone | 256-799-2500
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1-129748
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License Number State | AL
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