Provider Demographics
NPI:1013562784
Name:O'BRIEN, DANIELLE (APRN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CLIFDON DR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1263
Mailing Address - Country:US
Mailing Address - Phone:203-554-7471
Mailing Address - Fax:
Practice Address - Street 1:PLAINVILLE INTERNAL MEDICINE
Practice Address - Street 2:120 WEST MAIN STREET
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1944
Practice Address - Country:US
Practice Address - Phone:860-747-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8379363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily