Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 101046 | NV |
N | 124Q00000X | Dental Hygienist | 2079 | AK |
N | 124Q00000X | Dental Hygienist | 22249 | CA |
Y | 124Q00000X | Dental Hygienist | 367 | CA |
N | 126800000X | Dental Assistant | 05238 | CA |
NPI | 1346530045 |
---|---|
Provider Name | Ms. Deborah Kaye Osborn |
First Address | Reno, NV 89511-2870 |
Second Address | Reno, NV 89521-5032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2011 |
Last Update Date | 05/11/2011 |