Healthcare Provider Details

I. General information

NPI: 1285264473
Provider Name (Legal Business Name): OBRIEN ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 WINCHESTER ST
KEENE NH
03431-4634
US

IV. Provider business mailing address

84 FOXBERRY DR
NEW BOSTON NH
03070-4315
US

V. Phone/Fax

Practice location:
  • Phone: 908-392-0381
  • Fax:
Mailing address:
  • Phone: 908-392-0381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER OBRIEN
Title or Position: OWNER
Credential: CRNA
Phone: 908-392-0381