Provider Demographics
NPI:1588857585
Name:O'BRIEN, ROBERT P (LPN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-4717
Mailing Address - Country:US
Mailing Address - Phone:513-571-8037
Mailing Address - Fax:
Practice Address - Street 1:600 STANLEY ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-4717
Practice Address - Country:US
Practice Address - Phone:513-571-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.127012-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse