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General NPI Number Information
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NPI Number | 1457485328
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Entity Type | Individual
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Provider Name | JULIE L O'BRIEN APN, CNS
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 8600 N STATE ROUTE 91
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City | PEORIA
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State | IL
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Zip | 61615-9541
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Country | US
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Telephone | 309-683-5409
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Fax | 309-683-5428
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Provider Business Mailing Address
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Address Line | 8600 N ROUTE 91
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City | PEORIA
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State | IL
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Zip | 61615
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Country | US
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Telephone | 309-683-5051
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Fax | 309-683-5428
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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 | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 209002981
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209006476
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 209-002981
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License Number State | IL
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