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General NPI Number Information
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NPI Number | 1336803378
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Entity Type | Individual
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Provider Name | ABIGAIL O'BRIEN APNP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 3030 LAURA LN
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City | MIDDLETON
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State | WI
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Zip | 53562-1872
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Country | US
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Telephone | 888-688-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 533 S SHORE DR
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City | MADISON
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State | WI
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Zip | 53715-1703
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Country | US
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Telephone | 608-219-8877
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11496-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 234607-30
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License Number State | WI
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