Provider Demographics
NPI:1437396058
Name:O'CONNOR, EILEEN MARIE (PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARIE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4977 BATTERY LANE
Mailing Address - Street 2:#914
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4927
Mailing Address - Country:US
Mailing Address - Phone:301-951-4785
Mailing Address - Fax:
Practice Address - Street 1:6900 GEORGIA AVE.,NW
Practice Address - Street 2:WALTER REED ARMY MEDICAL CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-782-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN26400163WP0809X
MDRO72050163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult