Healthcare Provider Details

I. General information

NPI: 1043097827
Provider Name (Legal Business Name): ROBIN O'NEILL DNP, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N WASHINGTON ST STE 100
FALLS CHURCH VA
22046-3436
US

IV. Provider business mailing address

6376 SAINT TIMOTHYS LN
CENTREVILLE VA
20121-4827
US

V. Phone/Fax

Practice location:
  • Phone: 703-359-5100
  • Fax: 703-241-1863
Mailing address:
  • Phone: 339-223-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT28689308
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: