Provider Demographics
NPI:1881005544
Name:O'CONNOR, INA MAE (RN)
Entity Type:Individual
Prefix:
First Name:INA
Middle Name:MAE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:INA
Other - Middle Name:MAE
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1228 HILL ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-8226
Mailing Address - Country:US
Mailing Address - Phone:509-470-6766
Mailing Address - Fax:509-470-6766
Practice Address - Street 1:1228 HILL ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8226
Practice Address - Country:US
Practice Address - Phone:509-470-6766
Practice Address - Fax:509-470-6766
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166663163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse