Provider Demographics
NPI:1851185789
Name:O'BRIEN, MARYANNE (NP)
Entity type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 N MERIDIAN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1814
Mailing Address - Country:US
Mailing Address - Phone:317-669-0820
Mailing Address - Fax:855-618-2432
Practice Address - Street 1:9333 N MERIDIAN ST STE 110
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1814
Practice Address - Country:US
Practice Address - Phone:317-669-0820
Practice Address - Fax:855-618-2432
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016378A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health