Healthcare Provider Details

I. General information

NPI: 1538520168
Provider Name (Legal Business Name): MARIE OCONNELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 S PARKER RD
AURORA CO
80014-1622
US

IV. Provider business mailing address

4373 WESTBROOKE CT
FORT COLLINS CO
80526-3451
US

V. Phone/Fax

Practice location:
  • Phone: 303-636-2948
  • Fax:
Mailing address:
  • Phone: 847-971-6792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN.1634416
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: