Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 101.0093140 | VT |
N | 363LC1500X | Nurse Practitioner - Community Health | AP101028 | ME |
NPI | 1033421110 |
---|---|
Provider Name | Ms. Megan Marie O'brien |
First Address | Burlington, VT 05401-1601 |
Second Address | Burlington, VT 05401-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 10/04/2019 |