Provider Demographics
NPI:1417413113
Name:ONEILL, CATHERINE IRENE (PA-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:IRENE
Last Name:ONEILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:IRENE
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:829 N CENTER AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1599
Mailing Address - Country:US
Mailing Address - Phone:989-731-7860
Mailing Address - Fax:989-731-7833
Practice Address - Street 1:829 N CENTER AVE STE 210
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1599
Practice Address - Country:US
Practice Address - Phone:989-731-7860
Practice Address - Fax:989-731-7833
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601008978363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical