Individual
HALLIE T O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
500 CLINIC DR, HOPKINSVILLE, KY 42240-4991
(270) 707-3300
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002153
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044288
BCBS PROVIDER NUMBER
—
01
—
2153P
LICENSE
KY
05
—
78001856
—
KY
Enumeration date
09/28/2006
Last updated
03/31/2015
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