Healthcare Provider Details

I. General information

NPI: 1427729433
Provider Name (Legal Business Name): KAYLA MARIE O'NEIL MSN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLA MARIE CATALANO RN BSN CCRN

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

25 TAMWORTH HILL AVE
WAKEFIELD MA
01880-4213
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2000
  • Fax:
Mailing address:
  • Phone: 781-640-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN2283683
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: