Basic Information
| Provider Information | |||||||||
| NPI: | 1265936736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'REILLY | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 CUNNINGHAM DR | ||||||||
| Address2: | |||||||||
| City: | SOUTH HAMILTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019821815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788104044 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 195 SCHOOL ST | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785264311 | ||||||||
| FaxNumber: | 9785252342 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2018 | ||||||||
| LastUpdateDate: | 06/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2268440 | MA | N | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | 363LA2200X | AG03180073 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LF0000X | RN2268440 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.