Provider Demographics
NPI:1508629924
Name:O'BRIEN, VANESSA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LPN
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 894
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-0894
Mailing Address - Country:US
Mailing Address - Phone:740-242-2300
Mailing Address - Fax:740-899-8070
Practice Address - Street 1:14882 STATE ROUTE 13
Practice Address - Street 2:
Practice Address - City:THORNVILLE
Practice Address - State:OH
Practice Address - Zip Code:43076-8954
Practice Address - Country:US
Practice Address - Phone:740-242-2300
Practice Address - Fax:740-899-8070
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH184230164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse