Provider Demographics
NPI:1538838719
Name:OBRIEN, CAITLIN DEAN (APRN)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:DEAN
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:DR
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:183 HARBOUR WATCH WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2857
Mailing Address - Country:US
Mailing Address - Phone:443-262-5903
Mailing Address - Fax:
Practice Address - Street 1:9231 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9101
Practice Address - Country:US
Practice Address - Phone:843-572-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty