Individual provider Active NPI

Kimberly Anne O'Brien, RN

  • Registered Nurse
  • Davenport, IA
National Provider Identifier
1376404624
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
123629 Issued in IA
Practice address
2826 W Locust St
Davenport, IA 52804-3354
Phone
(563) 343-9256
Fax
(563) 445-8676
NPI assigned
Nov 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041389701 IL
Registered Nurse 163W00000X 123629 IA Primary

Addresses

Primary practice location

2826 W Locust St
Davenport, IA 52804-3354

Mailing address

2826 W Locust St
Davenport, IA 52804-3354
Phone (563) 343-9256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
123629IAMDRegistered Nurse
041389701ILMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1376404624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 W LOCUST ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528043354",
            "telephone_number": "563-343-9256",
            "fax_number": "563-445-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 W LOCUST ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528043354",
            "telephone_number": "563-343-9256",
            "fax_number": "563-445-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041389701",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "123629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.