Provider Demographics
NPI:1205431921
Name:O'NEAL, ADRIENNE SOPHIE (NP-C)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:SOPHIE
Last Name:O'NEAL
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 1:1726 CREST WAY
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-2556
Mailing Address - Country:US
Mailing Address - Phone:207-278-1332
Mailing Address - Fax:
Practice Address - Street 1:1726 CREST WAY
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-2556
Practice Address - Country:US
Practice Address - Phone:307-278-1332
Practice Address - Fax:307-278-1338
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY46873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily