Provider Demographics
NPI:1689641573
Name:O'BRIEN, ELIZABETH T (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0937
Mailing Address - Country:US
Mailing Address - Phone:704-403-1308
Mailing Address - Fax:704-403-1194
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:SUITE 330
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0937
Practice Address - Country:US
Practice Address - Phone:704-403-1308
Practice Address - Fax:704-403-1194
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2022-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC900354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP67527Medicare UPIN
NCNCE891C904Medicare PIN