=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831687144
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL O'BRIEN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2018
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 316 GIFFORD ST STE 1
-----------------------------------------------------
City | FALMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02540-2962
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 857-328-0724
-----------------------------------------------------
Fax | 949-703-7789
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 BEATTIE PL STE 810
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29601-2191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | RN2320615
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------