Provider Demographics
NPI:1669235040
Name:O'BRIEN, PATRICK (RDN, CSSD, MS)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:RDN, CSSD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 MELPARK DR APT 252
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2278
Mailing Address - Country:US
Mailing Address - Phone:757-345-1140
Mailing Address - Fax:
Practice Address - Street 1:725 MELPARK DR APT 252
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2278
Practice Address - Country:US
Practice Address - Phone:757-345-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10406133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics