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NPI Code Detail

MEDICARE: THOMAS JAMES O'BRIEN CRNA

MEDICARE: THOMAS JAMES O'BRIEN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist109596NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1430073189OTHERNCRAILROAD-MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740317403
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS JAMES O'BRIEN CRNA
Provider Business Mailing Address
First Line : PO BOX 18139
Second Line :
City : RALEIGH
State : NC
Zip : 27619-8139
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1705 TARBORO ST SW
Second Line :
City : WILSON
State : NC
Zip : 27893-3428
Country : US
Telephone Number : 252-399-8688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 03/15/2026

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