Provider Demographics
NPI:1942311055
Name:O'BRIEN, ELIZABETH (NP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16950 VIA TAZON
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1607
Mailing Address - Country:US
Mailing Address - Phone:858-499-2702
Mailing Address - Fax:
Practice Address - Street 1:16950 VIA TAZON
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1607
Practice Address - Country:US
Practice Address - Phone:858-499-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN494828363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology