MEDICARE: ROSE OSAMUDIAMEN OJO DNP, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP031551	PA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP.AP.70047426-NP	WA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2339057	MA
4	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN2339057	MA
5	163W00000X	Registered Nurse	RN796831	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP.AP.70047426-NP	OTHER	WA	PSYCHIATRY
2	SP031551	OTHER	PA	PSYCHIATRIC NURSE PRACTITIONER

General Provider Information

NPI Number	:	1467116756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE OSAMUDIAMEN OJO DNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 2887
Second Line	:
City	:	LYNN
State	:	MA
Zip	:	01903-2887
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	199 ROSEWOOD DR STE 300
Second Line	:
City	:	DANVERS
State	:	MA
Zip	:	01923-1388
Country	:	US
Telephone Number	:	197-849-4816
Fax Number	:	978-233-3063

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

Provider Enumeration Date	:	10/24/2021
Last Update Date	:	11/08/2025

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