Healthcare Provider Details

I. General information

NPI: 1215145917
Provider Name (Legal Business Name): ROXANNE O'NEILL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROXANNE FRYAR BSW

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S STATE ST
BASSETT NE
68714-5062
US

IV. Provider business mailing address

1615 N 4TH ST
ONEILL NE
68763-1178
US

V. Phone/Fax

Practice location:
  • Phone: 402-684-2908
  • Fax:
Mailing address:
  • Phone: 402-340-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1313
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: