Provider Demographics
NPI:1619990777
Name:O'NEIL, JENNY ELIZABETH (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:ELIZABETH
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 E LAYTON DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2819
Mailing Address - Country:US
Mailing Address - Phone:913-971-3755
Mailing Address - Fax:
Practice Address - Street 1:2030 E COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1851
Practice Address - Country:US
Practice Address - Phone:913-780-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-00305390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program