Provider Demographics
NPI:1972774552
Name:O'BYRNE, ROBERT TIMOTHY (APMH-NP/CNS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:O'BYRNE
Suffix:
Gender:M
Credentials:APMH-NP/CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 RAINTREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3749
Mailing Address - Country:US
Mailing Address - Phone:757-621-5765
Mailing Address - Fax:
Practice Address - Street 1:4020 RAINTREE RD STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3749
Practice Address - Country:US
Practice Address - Phone:757-606-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM59180363LP0808X
VA0024166755363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health