Provider Demographics
NPI:1144617093
Name:O'CONNOR, BRIGID (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:BRIGID
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:HAINES
Mailing Address - State:AK
Mailing Address - Zip Code:99827-0717
Mailing Address - Country:US
Mailing Address - Phone:907-766-3300
Mailing Address - Fax:907-766-3894
Practice Address - Street 1:259 MAIN ST.
Practice Address - Street 2:SUITE 21
Practice Address - City:HAINES
Practice Address - State:AK
Practice Address - Zip Code:99827
Practice Address - Country:US
Practice Address - Phone:907-766-3300
Practice Address - Fax:907-766-3894
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK37803163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse