Provider Demographics
NPI:1871875161
Name:OBRIEN, DAWN MARIE (RPH)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S COMMERCIAL STREET
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956
Mailing Address - Country:US
Mailing Address - Phone:920-729-1311
Mailing Address - Fax:920-729-0879
Practice Address - Street 1:500 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3383
Practice Address - Country:US
Practice Address - Phone:920-729-1311
Practice Address - Fax:920-729-0879
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11942-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist