Provider Demographics
NPI:1790467173
Name:O'NEAL, SHIRLEY FRIAS (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:FRIAS
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:SHIRLEY MARIA FLOR
Other - Middle Name:MENDOZA
Other - Last Name:FRIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1133 KILLINGTON ARCH
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8255
Mailing Address - Country:US
Mailing Address - Phone:757-773-9442
Mailing Address - Fax:
Practice Address - Street 1:1009 CENTERBROOKE LN STE 201
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8664
Practice Address - Country:US
Practice Address - Phone:757-209-4794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001261175163W00000X
VA0024187882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse