MEDICARE: WILLIAM OHARA PHMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	287014	AZ

General Provider Information

NPI Number	:	1982301859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM OHARA PHMHNP-BC

Provider Business Mailing Address
First Line	:	826 WILLITS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-4698
Country	:	US
Telephone Number	:	480-980-7309
Fax Number	:

Provider Business Practice Location Address
First Line	:	4282 N QUAIL CANYON DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6917
Country	:	US
Telephone Number	:	520-612-0466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/03/2026

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Directions to “ WILLIAM OHARA PHMHNP-BC” Practice Location

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