Provider Demographics
NPI:1043646904
Name:OSBORNE, PATRICIA GOAD (FNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GOAD
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-1405
Mailing Address - Country:US
Mailing Address - Phone:276-728-4311
Mailing Address - Fax:276-728-0901
Practice Address - Street 1:702 PINE ST
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-1405
Practice Address - Country:US
Practice Address - Phone:276-728-4311
Practice Address - Fax:276-728-0901
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily