Healthcare Provider Details

I. General information

NPI: 1801508148
Provider Name (Legal Business Name): COLLEEN THERESE O'BRIEN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN THERESE O'BRIEN DNP, FNP-BC

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CALHOUN ST
CHARLESTON SC
29401-1113
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2450
  • Fax: 843-724-2455
Mailing address:
  • Phone: 888-472-0043
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26846
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: