Provider Demographics
NPI:1033522602
Name:O'MEARA, TRISHA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:LYNN
Last Name:O'MEARA
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 1:747 VOLVO PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1615
Mailing Address - Country:US
Mailing Address - Phone:757-547-7546
Mailing Address - Fax:757-437-8200
Practice Address - Street 1:747 VOLVO PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1615
Practice Address - Country:US
Practice Address - Phone:757-547-7546
Practice Address - Fax:757-437-8200
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner