Doctor Name: | KIMBERLY ANN OBRIEN |
NPI Number: | 1164551289 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | C0003955 |
Business Practice Address: | 101 Clinic Dr Tarboro, NC - 278861935 |
Business Phone Number: | 2528234245 |
Business Fax Number: | |
Mailing Address: | 101 Clinic Dr, TARBORO |
State: | NC |
Postal Code: | 278861935 |
Phone Number: | 2528234245 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 04/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | C0003955 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |