Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN2284728 | MA |
NPI | 1013389386 |
---|---|
Provider Name | Ms. Louise Ambler Osborn |
First Address | Boston, MA 02215-5306 |
Second Address | Boston, MA 02215-5306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2015 |
Last Update Date | 27/10/2015 |