Doctor Name: | JUANITA M O'BRIEN |
NPI Number: | 1215080759 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | A053029 |
Business Practice Address: | 623 Pennsylvania Ave Ottumwa, IA - 525012116 |
Business Phone Number: | 6416827571 |
Business Fax Number: | |
Mailing Address: | 623 Pennsylvania Ave, OTTUMWA |
State: | IA |
Postal Code: | 525012116 |
Phone Number: | 6416827571 |
Fax Number: | |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A053029 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |