Healthcare Provider Details

I. General information

NPI: 1598805079
Provider Name (Legal Business Name): MARYBETH L O NEIL CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARYBETH L PARTINGTON CNS

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 CAMPUS DR SE ROCHESTER
ROCHESTER MN
55904-4831
US

IV. Provider business mailing address

2100 CAMPUS DR SE ROCHESTER
ROCHESTER MN
55904-4831
US

V. Phone/Fax

Practice location:
  • Phone: 507-259-5329
  • Fax:
Mailing address:
  • Phone: 507-259-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR 097255-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: