Healthcare Provider Details

I. General information

NPI: 1912336256
Provider Name (Legal Business Name): MRS. DANNA OBRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 E CALVADA BLVD SUITE 900
PAHRUMP NV
89048-5847
US

IV. Provider business mailing address

1440 E CALVADA BLVD SUITE 900
PAHRUMP NV
89048-5847
US

V. Phone/Fax

Practice location:
  • Phone: 775-727-4000
  • Fax: 775-727-4007
Mailing address:
  • Phone: 775-727-4000
  • Fax: 775-727-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: