Healthcare Provider Details

I. General information

NPI: 1760904775
Provider Name (Legal Business Name): ALLISON BEHETTE OBRIEN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 TYSONS BLVD STE 300
TYSONS VA
22102-4285
US

IV. Provider business mailing address

1530 CLARENDON BLVD APT 210
ARLINGTON VA
22209-4308
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone: 347-204-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC002092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: