MEDICARE: MRS. STEPHANIE ROSE O'NEIL

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
1	363L00000X	Nurse Practitioner	083803-23	NH

General Provider Information

NPI Number	:	1912880816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE ROSE O'NEIL

Provider Business Mailing Address
First Line	:	13 APACHE ST
Second Line	:
City	:	DOVER
State	:	NH
Zip	:	03820-6208
Country	:	US
Telephone Number	:	781-686-6159
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 BORTHWICK AVE STE 101
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-4102
Country	:	US
Telephone Number	:	603-436-7171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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