Provider Demographics
NPI:1306942263
Name:ONEILL, KATHLEEN M (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:ONEILL
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:850 CENTRAL PKWY E
Mailing Address - Street 2:STE 275
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 CENTRAL PKWY E
Practice Address - Street 2:STE 275
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5561
Practice Address - Country:US
Practice Address - Phone:972-372-1656
Practice Address - Fax:972-372-1657
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2017-02-17
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Provider Licenses
StateLicense IDTaxonomies
TX612129363LA2200X, 363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206111101Medicaid