Provider Demographics
NPI:1447510151
Name:O'BRIEN, MICHELE MARIE (LPN)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1206
Mailing Address - Country:US
Mailing Address - Phone:330-468-5921
Mailing Address - Fax:
Practice Address - Street 1:31 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1206
Practice Address - Country:US
Practice Address - Phone:330-468-5921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN087477164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse