Basic Information
| Provider Information | |||||||||
| NPI: | 1528581618 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | O'NEIL | ||||||||
| FirstName: | ADREA | ||||||||
| MiddleName: | N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 38 | ||||||||
| Address2: | |||||||||
| City: | CORYDON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471120038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8127386040 | ||||||||
| FaxNumber: | 8127386040 | ||||||||
| Practice Location | |||||||||
| Address1: | 4915 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402162501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154254200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2017 | ||||||||
| LastUpdateDate: | 01/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 71007274A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 71007274A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 3012772 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.