Provider Demographics
NPI:1285851816
Name:O'BRIEN, PATRICIA (RR, CPNP-AC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:RR, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 THEODORE PARKER RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1119
Mailing Address - Country:US
Mailing Address - Phone:617-469-4828
Mailing Address - Fax:617-734-1034
Practice Address - Street 1:144 THEODORE PARKER RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-1119
Practice Address - Country:US
Practice Address - Phone:617-469-4828
Practice Address - Fax:617-734-1034
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179647363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics