Provider Demographics
NPI:1871905307
Name:OSBORNE, MICHELLE URQUHART (NP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:URQUHART
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:ALLISON
Other - Last Name:URQUHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7501 SURRATTS RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3362
Mailing Address - Country:US
Mailing Address - Phone:301-877-5607
Mailing Address - Fax:855-570-5343
Practice Address - Street 1:7501 SURRATTS RD
Practice Address - Street 2:SUITE 303
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3362
Practice Address - Country:US
Practice Address - Phone:301-877-5607
Practice Address - Fax:855-570-5343
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN967611363LF0000X
MDR163102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily