Healthcare Provider Details

I. General information

NPI: 1235456211
Provider Name (Legal Business Name): CYNTHIA LYNNE O'BRIEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N RIVER ST NW
CALHOUN GA
30701-9408
US

IV. Provider business mailing address

1620 HICKORY ST SUITE 404
DALTON GA
30720-2312
US

V. Phone/Fax

Practice location:
  • Phone: 706-625-8369
  • Fax: 706-625-8427
Mailing address:
  • Phone: 706-270-5002
  • Fax: 706-270-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN089442
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: