Provider Demographics
NPI:1033147582
Name:O'NEILL-CONOVER, CATHERINE R (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:O'NEILL-CONOVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 CAMINO ALEGRE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-9513
Mailing Address - Country:US
Mailing Address - Phone:760-942-2793
Mailing Address - Fax:
Practice Address - Street 1:3445 CAMINO ALEGRE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-9513
Practice Address - Country:US
Practice Address - Phone:760-942-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP13636FMedicare ID - Type Unspecified
CAWNP13636BMedicare ID - Type Unspecified
CAWNP13636EMedicare ID - Type Unspecified
CAWNP13636CMedicare ID - Type Unspecified
CAP64546Medicare UPIN
CAWNP13636AMedicare ID - Type Unspecified
CAWNP13636DMedicare ID - Type Unspecified