Healthcare Provider Details

I. General information

NPI: 1528198199
Provider Name (Legal Business Name): ELIZABETH GRACE O'NEIL RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH GRACE ARMSTRONG RN, NP

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1041
US

IV. Provider business mailing address

115 MILL ST
BELMONT MA
02478-1041
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-2438
  • Fax: 617-855-2730
Mailing address:
  • Phone: 617-855-2438
  • Fax: 617-855-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number156246
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: