Provider Demographics
NPI:1740970359
Name:OBRIEN, MARY CATHRYN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHRYN
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 ANNE LN
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-7220
Mailing Address - Country:US
Mailing Address - Phone:843-754-4282
Mailing Address - Fax:
Practice Address - Street 1:2921 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6332
Practice Address - Country:US
Practice Address - Phone:405-703-3116
Practice Address - Fax:405-757-7819
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK212390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily