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NPI Code Detail

MEDICARE: MS. CHRISTA L O'MARA FNP-C

MEDICARE: MS. CHRISTA L O'MARA FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP11351AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003975012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTA L O'MARA FNP-C
Provider Business Mailing Address
First Line : 2500 W UTOPIA RD STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-4172
Country : US
Telephone Number : 623-683-4462
Fax Number : 480-882-5814
Provider Business Practice Location Address
First Line : 7701 W ASPERA BLVD
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7947
Country : US
Telephone Number : 623-248-2108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 12/05/2024

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