Provider Demographics
NPI:1265990212
Name:O'NEILL, SHRIPRIYA MOHAN (CPNP)
Entity type:Individual
Prefix:
First Name:SHRIPRIYA
Middle Name:MOHAN
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 GENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305-1816
Mailing Address - Country:US
Mailing Address - Phone:585-771-0661
Mailing Address - Fax:202-448-7619
Practice Address - Street 1:3023 HAMAKER CT STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2240
Practice Address - Country:US
Practice Address - Phone:703-280-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177244363L00000X, 363LP0200X
DCNP1049347363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty