MEDICARE: MRS. TORI GAIL OSGOOD NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	167765	CO
2	363LW0102X	Women's Health Nurse Practitioner	671978	TX
3	363LW0102X	Women's Health Nurse Practitioner	22463.342	WY
4	363LW0102X	Women's Health Nurse Practitioner	R54482	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124075965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TORI GAIL OSGOOD NP

Provider Business Mailing Address
First Line	:	111 S MONROE ST
Second Line	:	UNIT 105A
City	:	DENVER
State	:	CO
Zip	:	80209-3007
Country	:	US
Telephone Number	:	303-316-2713
Fax Number	:	303-316-2713

Provider Business Practice Location Address
First Line	:	950 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2706
Country	:	US
Telephone Number	:	303-813-7698
Fax Number	:	303-813-7673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	07/08/2007

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