Provider Demographics
NPI:1154156297
Name:O'BRIEN, MARI SUZANNE (RN)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:SUZANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 RICHTER AVE
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-1635
Mailing Address - Country:US
Mailing Address - Phone:210-488-2793
Mailing Address - Fax:
Practice Address - Street 1:153 RICHTER AVE
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1635
Practice Address - Country:US
Practice Address - Phone:210-488-2793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX526470163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse