Healthcare Provider Details

I. General information

NPI: 1326267717
Provider Name (Legal Business Name): JANET M O'BRIEN RN., PSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CHEVY LN
GLASGOW KY
42141-8062
US

IV. Provider business mailing address

181 CHEVY LN
GLASGOW KY
42141-8062
US

V. Phone/Fax

Practice location:
  • Phone: 270-646-7988
  • Fax: 270-678-5003
Mailing address:
  • Phone: 270-646-7988
  • Fax: 270-678-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1087304
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: