Provider Demographics
NPI:1225044407
Name:O'BRIEN, KATHLEEN ANNE (ANP-C, FNP-C, GNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:ANP-C, FNP-C, GNP-C
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 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:100 PECAN CROSSING DR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-6097
Practice Address - Country:US
Practice Address - Phone:830-596-6900
Practice Address - Fax:830-596-6901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110316363LG0600X, 363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP085N6092Medicaid
TXP085N6092Medicaid
TXP22737Medicare UPIN