Provider Demographics
NPI:1689645830
Name:OBRIEN, ANN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 KELLEYS TRL
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1918
Mailing Address - Country:US
Mailing Address - Phone:727-785-9411
Mailing Address - Fax:
Practice Address - Street 1:20 KELLEYS TRL
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-1918
Practice Address - Country:US
Practice Address - Phone:727-785-9411
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist