Provider Demographics
NPI:1376012831
Name:O'MEARA, ALISON (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:O'MEARA
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:106 FORESTCREST CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3889
Mailing Address - Country:US
Mailing Address - Phone:651-373-7732
Mailing Address - Fax:
Practice Address - Street 1:9825 HOSPITAL DR STE 105
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4769
Practice Address - Country:US
Practice Address - Phone:763-780-6699
Practice Address - Fax:763-420-0500
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC321771163W00000X
MN2082592163W00000X
MN6256363LG0600X
NC5015223363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse