MEDICARE: NICOLA OSBORNE

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	11035782	FL

General Provider Information

NPI Number	:	1982428165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLA OSBORNE

Provider Business Mailing Address
First Line	:	6268 W SAMPLE RD STE 441
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3272
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6268 W SAMPLE RD STE 441
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3272
Country	:	US
Telephone Number	:	954-842-1103
Fax Number	:

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

Provider Enumeration Date	:	11/13/2024
Last Update Date	:	11/13/2024

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Directions to “ NICOLA OSBORNE ” Practice Location

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