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General NPI Number Information
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NPI Number | 1346341625
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Entity Type | Individual
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Provider Name | KATHLEEN GAIL OBRIEN MS RN NP CS
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 465 NORTH MAIN STREET
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City | PENN YAN
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State | NY
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Zip | 14527
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Country | US
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Telephone | 315-531-2400
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Fax | 315-531-2436
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Provider Business Mailing Address
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Address Line | 180 LAFAYETTE PARKWAY
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City | ROCHESTER
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State | NY
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Zip | 14625
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Country | US
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Telephone | 585-381-9714
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F4005441
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License Number State | NY
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