Provider Demographics
NPI:1710627831
Name:O'NEILL, SEAN MICHAEL (AGACNP, MSN, RN)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:AGACNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 ROCKSIDE WOODS BLVD S STE 330
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2222
Mailing Address - Country:US
Mailing Address - Phone:216-293-4984
Mailing Address - Fax:
Practice Address - Street 1:6480 ROCKSIDE WOODS BLVD S STE 330
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2222
Practice Address - Country:US
Practice Address - Phone:216-293-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030707363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care