Provider Demographics
NPI:1932152725
Name:O'BRIEN, SEAN M (CRNA)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:M
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NEW DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03855-2119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3073 WHITE MTN HWY
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5001
Practice Address - Country:US
Practice Address - Phone:603-356-5461
Practice Address - Fax:603-356-7651
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226762367500000X
NH045179-23-11367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered