Provider Demographics
NPI:1396225082
Name:O'LEARY-TAYLOR, CHARITY LYNN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:LYNN
Last Name:O'LEARY-TAYLOR
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12398 E DEL RICO
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-7363
Mailing Address - Country:US
Mailing Address - Phone:951-751-0612
Mailing Address - Fax:
Practice Address - Street 1:2851 S AVENUE B STE 2901
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7756
Practice Address - Country:US
Practice Address - Phone:928-304-7729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN196190163W00000X, 163WS0200X
AZ267356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool