Individual
MARY ANN O'BEIRNE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
21 BELMONT AVE, BRATTLEBORO, VT 05301-7110
(802) 258-3905
(802) 258-4903
Mailing address
600 BLAIR PARK RD, SUITE 190, WILLISTON, VT 05495-7586
(802) 860-1145
(802) 872-0282
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
055-0030498
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVNP1782
—
VT
Enumeration date
04/18/2006
Last updated
07/08/2007
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