Provider Demographics
NPI:1689128324
Name:O NEILL, EILENE MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:EILENE
Middle Name:MARIE
Last Name:O NEILL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 VALLEY HEALTH WAY # 300
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-6480
Mailing Address - Country:US
Mailing Address - Phone:540-631-3700
Mailing Address - Fax:
Practice Address - Street 1:351 VALLEY HEALTH WAY # 300
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6480
Practice Address - Country:US
Practice Address - Phone:540-631-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily