Individual
JOANNE M O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
180 MELTON RD, CRESWELL, OR 97426
(541) 222-7700
(541) 895-5426
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1253
(360) 729-3185
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201602228NP-PP
OR
363LF0000X
Family Nurse Practitioner
48178
WV
363LF0000X
Family Nurse Practitioner
COA.07283.NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000680676
ANTHEM
OH
01
—
000000699826
ANTHEM
OH
05
—
2398641
—
OH
05
—
3810011350
—
WV
01
—
P01346092
RAILROAD MEDICARE - MHCPI
OH
Enumeration date
10/04/2006
Last updated
01/02/2019
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