Healthcare Provider Details

I. General information

NPI: 1669606596
Provider Name (Legal Business Name): KATHLEEN F.M. O'NEILL R.N., C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 BRANDYWINE ST NW SUITE 300
WASHINGTON DC
20016-1876
US

IV. Provider business mailing address

4001 BRANDYWINE ST NW SUITE 300
WASHINGTON DC
20016-1876
US

V. Phone/Fax

Practice location:
  • Phone: 202-331-1740
  • Fax: 202-420-7222
Mailing address:
  • Phone: 202-331-1740
  • Fax: 202-420-7222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR184421
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: