Healthcare Provider Details

I. General information

NPI: 1457972796
Provider Name (Legal Business Name): LINDSEY MARIE O'BRIEN CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 HORNETS NEST WAY
CHARLOTTE NC
28208-5224
US

IV. Provider business mailing address

3423 HORNETS NEST WAY
CHARLOTTE NC
28208-5224
US

V. Phone/Fax

Practice location:
  • Phone: 919-744-6221
  • Fax:
Mailing address:
  • Phone: 919-744-6221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5013072
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number5013072
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: