Healthcare Provider Details

I. General information

NPI: 1164467346
Provider Name (Legal Business Name): PATRICIA ANNE O'BRIEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 WORTH ST
HEMPHILL TX
75948-7223
US

IV. Provider business mailing address

1923 BEACHROCK DRIVE
BROOKELAND TX
75966
US

V. Phone/Fax

Practice location:
  • Phone: 409-787-1707
  • Fax: 409-787-1730
Mailing address:
  • Phone: 409-983-1161
  • Fax: 409-983-4933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number721682
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: