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Individual

KELLY MARIE O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
4663 AUTUMNDALE DR, PACE, FL 32571-1394
(850) 776-3325
Mailing address
4663 AUTUMNDALE DR, PACE, FL 32571-1394
(850) 776-3325

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN9196840
FL
363L00000X
Nurse Practitioner
Primary
APRN11011201
FL
363LF0000X
Family Nurse Practitioner
11011201
FL

Other

Enumeration date
12/17/2020
Last updated
04/18/2022
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