Healthcare Provider Details

I. General information

NPI: 1760801369
Provider Name (Legal Business Name): CATHERINE O'NEILL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 S MILL AVE STE 206214
TEMPE AZ
85281-5652
US

IV. Provider business mailing address

1492 S MILL AVE STE 206214
TEMPE AZ
85281-5652
US

V. Phone/Fax

Practice location:
  • Phone: 623-288-3656
  • Fax: 480-508-0891
Mailing address:
  • Phone: 623-288-3656
  • Fax: 480-508-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5528
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP5528
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: