Healthcare Provider Details

I. General information

NPI: 1013123843
Provider Name (Legal Business Name): LORNA A. O'BRIEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 WESTBOURNE RD
ROCHESTER NY
14617-4534
US

IV. Provider business mailing address

44 WESTBOURNE RD
ROCHESTER NY
14617-4534
US

V. Phone/Fax

Practice location:
  • Phone: 585-338-7527
  • Fax:
Mailing address:
  • Phone: 585-338-7527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number436344-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: