Provider Demographics
NPI:1952752339
Name:OSBORN, BRITTANY MARIE (CNM)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 MOUND DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3636
Mailing Address - Country:US
Mailing Address - Phone:912-318-7391
Mailing Address - Fax:
Practice Address - Street 1:2651 E DISCOVERY PKWY
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-9059
Practice Address - Country:US
Practice Address - Phone:812-918-3400
Practice Address - Fax:812-918-5829
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015779A367A00000X
FLAPRN11003923367A00000X
IN09000478C367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300099054Medicaid
IN1101989222OtherANTHEM PTAN