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NPI Code Detail

MEDICARE: KATIE O'BRIEN RN

MEDICARE:   KATIE  O'BRIEN  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR1911541MN

General Provider Information

NPI Number : 1063899201
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE O'BRIEN RN
Provider Business Mailing Address
First Line : 2060 CENTRE POINTE BLVD
Second Line : SUITE 3
City : SAINT PAUL
State : MN
Zip : 55120-1269
Country : US
Telephone Number : 651-774-0011
Fax Number :
Provider Business Practice Location Address
First Line : 317 YORK AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55130-4039
Country : US
Telephone Number : 651-774-0202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2015
Last Update Date : 09/07/2023

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