Provider Demographics
NPI:1386935377
Name:O'BRIEN, JEANNE M (RN)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:M
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 1:83246 535TH AVE.
Mailing Address - Street 2:
Mailing Address - City:TILDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68781-8013
Mailing Address - Country:US
Mailing Address - Phone:402-368-7758
Mailing Address - Fax:
Practice Address - Street 1:83246 535TH AVE.
Practice Address - Street 2:
Practice Address - City:TILDEN
Practice Address - State:NE
Practice Address - Zip Code:68781-8013
Practice Address - Country:US
Practice Address - Phone:402-368-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23865171M00000X, 372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47640607OtherN-FOCUS
NE47640607OtherN-FOCUS