Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 363LN0005X | VA |
NPI | 1114330172 |
---|---|
Provider Name | Rosemary O'neill |
First Address | Woodbridge, VA 22191-3311 |
Second Address | Woodbridge, VA 22191-3311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2014 |
Last Update Date | 08/06/2014 |