MEDICARE: MRS. SHANNON LEE OSBECK NNP

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	363LN0000X	Neonatal Nurse Practitioner	ARNP 3283912	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629400767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANNON LEE OSBECK NNP

Provider Business Mailing Address
First Line	:	2080 CHILD ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32214-5005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 CHILD ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32214-5005
Country	:	US
Telephone Number	:	304-542-7300
Fax Number	:

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

Provider Enumeration Date	:	07/31/2013
Last Update Date	:	12/04/2025

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