Healthcare Provider Details

I. General information

NPI: 1528244720
Provider Name (Legal Business Name): KATHLEEN J OCONNOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD SUITE 213
OCALA FL
34470-6831
US

IV. Provider business mailing address

1515 E SILVER SPRINGS BLVD SUITE 213
OCALA FL
34470-6831
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-2100
  • Fax: 352-369-2134
Mailing address:
  • Phone: 352-369-2100
  • Fax: 352-369-2134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN567002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: