| Doctor Name: | VERNON ANTHONY OSBORN |
| NPI Number: | 1023491677 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | CNP-02704 |
| Business Practice Address: | 1447 E Roosevelt Ave Grants, NM - 870202245 |
| Business Phone Number: | 5052853445 |
| Business Fax Number: | |
| Mailing Address: | Hc 61 Box 1028, RAMAH |
| State: | NM |
| Postal Code: | 873219600 |
| Phone Number: | 5057754445 |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2015 |
| NPI Last Update Date: | 07/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP-02704 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |