Healthcare Provider Details
I. General information
NPI: 1821924002
Provider Name (Legal Business Name): SIAVHAN O'BRIEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
334 N MEDFORD DR
TUCSON AZ
85710-2571
US
IV. Provider business mailing address
334 N MEDFORD DR
TUCSON AZ
85710-2571
US
V. Phone/Fax
- Phone: 520-729-0327
- Fax:
- Phone: 520-729-0327
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | 341597 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: