Healthcare Provider Details

I. General information

NPI: 1588874895
Provider Name (Legal Business Name): DEBORAH ANNE OBRIEN RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 BLUE SPRUCE DR
FORT COLLINS CO
80524-2004
US

IV. Provider business mailing address

3374 WOODLANDS WAY
WELLINGTON CO
80549-3209
US

V. Phone/Fax

Practice location:
  • Phone: 970-498-6884
  • Fax: 970-498-6772
Mailing address:
  • Phone: 970-402-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1129414
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: