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General NPI Number Information
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NPI Number | 1053982652
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Entity Type | Individual
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Provider Name | ALISSA DANAE O'NEILL FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/05/2021
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 1818 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-1106
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Country | US
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Telephone | 620-259-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 1818 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-1106
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Country | US
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Telephone | 620-259-4444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-800083-061
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License Number State | KS
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