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General NPI Number Information
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NPI Number | 1649822305
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Entity Type | Individual
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Provider Name | CHRISTINE M O'NEAL CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL VILLAGE DR
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City | EDGEWOOD
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State | KY
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Zip | 41017-3403
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Country | US
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Telephone | 716-572-2877
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Fax |
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Provider Business Mailing Address
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Address Line | 340 THOMAS MORE PKWY STE 220
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-5101
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Country | US
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Telephone | 716-572-2877
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3014751
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License Number State | KY
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