MEDICARE: MEGAN J. OSBORN, PMHNP/ANP, PC

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	363LA2200X	Adult Health Nurse Practitioner	081000718N3	OR
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	200450036NP	OR

General Provider Information

NPI Number	:	1649430505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGAN J. OSBORN, PMHNP/ANP, PC

Provider Business Mailing Address
First Line	:	PO BOX 2719
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97308-2719
Country	:	US
Telephone Number	:	503-399-8200
Fax Number	:	503-363-2600

Provider Business Practice Location Address
First Line	:	1505 WATER ST NE
Second Line	:	SUITE 2
City	:	SALEM
State	:	OR
Zip	:	97301-6467
Country	:	US
Telephone Number	:	503-399-8200
Fax Number	:	503-363-2600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MEGAN JOANNA OSBORN
Credential	:	PMHNP/ANP
Telephone Number	:	503-399-8200

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	06/13/2008

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