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NPI Code Detail

MEDICARE: MS. KATHLEEN M ONEILL NURSE PRACTITIONER

MEDICARE: MS. KATHLEEN M ONEILL NURSE PRACTITIONER
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
1363LA2200XAdult Health Nurse Practitioner612129TX
2363LF0000XFamily Nurse Practitioner612129TX
3363LG0600XGerontology Nurse Practitioner612129TX

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 : 1306942263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN M ONEILL NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 850 CENTRAL PKWY E
Second Line : STE 275
City : PLANO
State : TX
Zip : 75074-5561
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 850 CENTRAL PKWY E
Second Line : STE 275
City : PLANO
State : TX
Zip : 75074-5561
Country : US
Telephone Number : 972-372-1656
Fax Number : 972-372-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 02/17/2017

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