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General NPI Number Information
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NPI Number | 1245539873
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Entity Type | Individual
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Provider Name | KATHLEEN OBUCHON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1251 FARMINGTON AVENUE
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-584-4535
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Fax | 860-584-4535
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Provider Business Mailing Address
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Address Line | 120 W MAIN ST
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City | PLAINVILLE
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State | CT
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Zip | 06062-1944
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Country | US
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Telephone | 860-747-0411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 003228
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License Number State | CT
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