Basic Information
Provider Information
NPI: 1497003214
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: O'NEILL
FirstName: ANNE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: CNP, PMHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 444 N MAIN ST FL 6
Address2:  
City: AKRON
State: OH
PostalCode: 443103110
CountryCode: US
TelephoneNumber: 3303798190
FaxNumber: 3303798191
Practice Location
Address1: 444 N MAIN ST FL 6
Address2:  
City: AKRON
State: OH
PostalCode: 443103110
CountryCode: US
TelephoneNumber: 3303798190
FaxNumber: 3303798191
Other Information
ProviderEnumerationDate: 08/28/2012
LastUpdateDate: 04/28/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XNP13741OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


Home