Individual
COLEEN E O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1001 BLYTHE BLVD., SUITE 200D, CHARLOTTE, NC 28203-6215
(704) 373-1813
(704) 373-1813
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(704) 631-0002
(704) 631-0002
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
300221
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
AP4492
AZ
363LP0200X
Pediatric Nurse Practitioner
RN173314
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710871
—
AZ
Enumeration date
05/30/2012
Last updated
02/17/2017
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