Provider Demographics
NPI:1154711695
Name:O'BRIEN, ADRIANNE JO (FNP)
Entity type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:JO
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ADRIANNE
Other - Middle Name:JO
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1260 S CAMPBELL AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0502
Mailing Address - Country:US
Mailing Address - Phone:520-407-5600
Mailing Address - Fax:
Practice Address - Street 1:1285 W CAMINO ENCANTO
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-8222
Practice Address - Country:US
Practice Address - Phone:520-625-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily