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General NPI Number Information
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NPI Number | 1902277999
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Entity Type | Individual
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Provider Name | VICTORIA JADE OSBORNE
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Gender | Female
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 8204 STONEBROOK PKWY
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City | FRISCO
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State | TX
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Zip | 75034-5536
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Country | US
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Telephone | 972-335-1407
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Fax |
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Provider Business Mailing Address
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Address Line | 13523 W MONTE VISTA CIR
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City | GOODYEAR
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State | AZ
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Zip | 85395-2435
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Country | US
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Telephone | 623-694-9176
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | AT6291
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License Number State | TX
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