Provider Demographics
NPI:1003480203
Name:O'HARA, JAMES (FNP-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:O'HARA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 W 109TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1202
Mailing Address - Country:US
Mailing Address - Phone:618-518-0872
Mailing Address - Fax:
Practice Address - Street 1:6807 W 121ST ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-2005
Practice Address - Country:US
Practice Address - Phone:913-356-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS80834363L00000X
IN71011131A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner