Healthcare Provider Details

I. General information

NPI: 1215097415
Provider Name (Legal Business Name): LORETTA O'HANLON NURSE PRACTIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 ARLINGTON ST
ASHEVILLE NC
28801-2006
US

IV. Provider business mailing address

16 ARLINGTON ST
ASHEVILLE NC
28801-2006
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-5795
  • Fax: 828-252-5646
Mailing address:
  • Phone: 828-252-5795
  • Fax: 828-252-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number156573
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number156573
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: