Provider Demographics
NPI:1003127358
Name:O'BRIEN, HAROLD DEAN (APRN)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:DEAN
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9426
Mailing Address - Country:US
Mailing Address - Phone:812-941-9200
Mailing Address - Fax:812-941-9205
Practice Address - Street 1:1357 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1353
Practice Address - Country:US
Practice Address - Phone:502-897-6443
Practice Address - Fax:502-897-3461
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003264A363LP0808X
KY3006723363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000668876OtherANTHEM