Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 5992 | MN |
NPI | 1003852229 |
---|---|
Provider Name | Ms. Carol Ann Obrien |
First Address | St Cloud, MN 56303-2614 |
Second Address | Buffalo, MN 55313-2321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101949 | OPTUM (01) | |
151284C851 | UCARE (01) | |
6250430 | MEDICA (01) | |
73Q840B | BCBS (01) | |
762672000 | (05) | MN |
922241025900 | PREFERRED ONE (01) | |
HP32385 | HEALTH PARTNERS (01) |