Healthcare Provider Details

I. General information

NPI: 1972979425
Provider Name (Legal Business Name): CAROL LYNNE ONEIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 WADDINGTON RD
COLUMBUS OH
43220-4447
US

IV. Provider business mailing address

4215 WADDINGTON RD
COLUMBUS OH
43220-4447
US

V. Phone/Fax

Practice location:
  • Phone: 614-459-2888
  • Fax:
Mailing address:
  • Phone: 614-459-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.189038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: