Healthcare Provider Details

I. General information

NPI: 1386526861
Provider Name (Legal Business Name): CRISTA O'NEIL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 RIDGEBROOK RD STE 300
SPARKS MD
21152-9477
US

IV. Provider business mailing address

2431 GLENALLAN AVE
SILVER SPRING MD
20906-3541
US

V. Phone/Fax

Practice location:
  • Phone: 407-414-9789
  • Fax:
Mailing address:
  • Phone: 301-679-3095
  • Fax: 301-597-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11039993
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: