Provider Demographics
NPI:1962100446
Name:O'BRIEN, CAITLYN ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ELIZABETH
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BRENTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3461
Mailing Address - Country:US
Mailing Address - Phone:781-835-8784
Mailing Address - Fax:
Practice Address - Street 1:3 WOODLAND RD STE 217
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1711
Practice Address - Country:US
Practice Address - Phone:781-395-2922
Practice Address - Fax:781-393-8905
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2333093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily