Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP010426 | PA |
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.020627 | OH |
N | 363LN0000X | Nurse Practitioner - Neonatal | SP001256J | PA |
NPI | 1114064128 |
---|---|
Provider Name | Mrs. Regina M O'leary |
First Address | Akron, OH 44308-1063 |
Second Address | Boardman, OH 44512-3457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 03/05/2017 |