Healthcare Provider Details

I. General information

NPI: 1043336258
Provider Name (Legal Business Name): JOHN F O'BRIEN A.P.R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

IV. Provider business mailing address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

V. Phone/Fax

Practice location:
  • Phone: 203-797-7118
  • Fax:
Mailing address:
  • Phone: 203-797-7118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number003588
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: