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NPI Code Detail

MEDICARE: KRISTINA H O'MEARA NP

MEDICARE: KRISTINA H O'MEARA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner0036169OH
2174400000XSpecialist0036169VA

General Provider Information

NPI Number : 1114933967
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA H O'MEARA NP
Provider Business Mailing Address
First Line : 1300 N COUNTY ROAD 25A
Second Line :
City : TROY
State : OH
Zip : 45373-1359
Country : US
Telephone Number : 937-332-0894
Fax Number : 937-339-7084
Provider Business Practice Location Address
First Line : 1300 N COUNTY ROAD 25A
Second Line :
City : TROY
State : OH
Zip : 45373-1359
Country : US
Telephone Number : 937-332-0894
Fax Number : 937-339-7084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 04/24/2024

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Directions to “ KRISTINA H O'MEARA NP” Practice Location

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