Healthcare Provider Details

I. General information

NPI: 1073171591
Provider Name (Legal Business Name): MEGAN O'BRIEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 CENTRAL AVE E
HAMPTON IA
50441-1869
US

IV. Provider business mailing address

1720 CENTRAL AVE E
HAMPTON IA
50441-1869
US

V. Phone/Fax

Practice location:
  • Phone: 641-456-5050
  • Fax:
Mailing address:
  • Phone: 641-445-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number097540
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number097540
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: