Healthcare Provider Details

I. General information

NPI: 1124909668
Provider Name (Legal Business Name): LAUREN W OBRIEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ELIZABETH ST
CORPUS CHRISTI TX
78404-2235
US

IV. Provider business mailing address

9626 WILKINS DR
CORPUS CHRISTI TX
78410-1534
US

V. Phone/Fax

Practice location:
  • Phone: 361-881-3000
  • Fax:
Mailing address:
  • Phone: 661-557-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1125882
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1125882
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: