Provider Demographics
NPI:1083614994
Name:OBRIEN, MARY T (RN MSN CNM)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:T
Last Name:OBRIEN
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Gender:F
Credentials:RN MSN CNM
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Mailing Address - Street 1:260 NEW LUDLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4324
Mailing Address - Country:US
Mailing Address - Phone:413-533-3470
Mailing Address - Fax:413-533-6859
Practice Address - Street 1:230 MAPLE STREET
Practice Address - Street 2:SUITE 200 MIDWIFERY CARE OF HOLYOKE
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6513
Practice Address - Country:US
Practice Address - Phone:413-535-4700
Practice Address - Fax:413-535-4704
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA188081367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
043202198OtherCIGNA
043202198OtherCBA
21220010314OtherBEECH STREET
CN0096OtherBCBS OF MA
40476OtherHEALTHY START