Provider Demographics
NPI:1255769469
Name:O'BRIEN, KRISTIN SARAH (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:SARAH
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 BRENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037
Mailing Address - Country:US
Mailing Address - Phone:704-812-7778
Mailing Address - Fax:704-812-7779
Practice Address - Street 1:539 BRENTWOOD RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037
Practice Address - Country:US
Practice Address - Phone:704-812-7778
Practice Address - Fax:704-812-7779
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist