Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 44446 | KS |
NPI | 1063635308 |
---|---|
Provider Name | Cheryl Lynnette O'halloran |
First Address | Olathe, KS 66062-6075 |
Second Address | Kansas City, KS 66112-1689 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |