Provider Demographics
NPI:1639762073
Name:OBRIEN, ASHLEY (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 SW ABALON CIR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-5717
Mailing Address - Country:US
Mailing Address - Phone:772-626-3412
Mailing Address - Fax:
Practice Address - Street 1:250 FORT ST
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357-4003
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9450884163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine