Provider Demographics
NPI:1124186770
Name:O BRIEN, LAURA MAY (FNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MAY
Last Name:O BRIEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0094
Mailing Address - Country:US
Mailing Address - Phone:530-692-2558
Mailing Address - Fax:
Practice Address - Street 1:8676 MARYSVILLE RD
Practice Address - Street 2:
Practice Address - City:OREGON HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95962-9718
Practice Address - Country:US
Practice Address - Phone:530-692-2558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421367163W00000X
CA6263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse