Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | E3720 | AR |
Y | 111NI0900X | Internist | E3720 | AR |
N | 2080A0000X | Adolescent Medicine | E3720 | AR |
NPI | 1194711697 |
---|---|
Provider Name | Rebecca Lynn Osborne |
First Address | Walnut Ridge, AR 72476-0839 |
Second Address | Walnut Ridge, AR 72476-1430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 10/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150035001 | (05) | AR |