Individual
MARK O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11505 39TH AVE N, PLYMOUTH, MN 55441-1310
(612) 751-7531
Mailing address
11505 39TH AVE N, PLYMOUTH, MN 55441-1310
(612) 751-7531
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
238058-2
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
238058-2
MN
Other
Enumeration date
08/31/2021
Last updated
12/12/2023
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