Healthcare Provider Details

I. General information

NPI: 1477078103
Provider Name (Legal Business Name): KRISTIN MEEGAN OBRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OCHRE POINT AVE OFFICE OF HEALTH SERVICES- MILEY HALL
NEWPORT RI
02840-1428
US

IV. Provider business mailing address

100 OCHRE POINT AVE OFFICE OF HEALTH SERVICES- MILEY HALL
NEWPORT RI
02840
US

V. Phone/Fax

Practice location:
  • Phone: 401-341-2904
  • Fax:
Mailing address:
  • Phone: 401-341-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN01630
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: