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General NPI Number Information
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NPI Number | 1982147393
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Entity Type | Individual
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Provider Name | SHANNON OSBORNE MPH, CNM, WHNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2900 DOOLITTLE DR
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City | ELLSWORTH AFB
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State | SD
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Zip | 57706-4821
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Country | US
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Telephone | 605-385-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 DOOLITTLE DR
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City | ELLSWORTH AFB
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State | SD
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Zip | 57706-4821
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | CNM03795
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | CNP020326
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License Number State | OH
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