Provider Demographics
NPI:1639115553
Name:O'LEARY, ELIZABETH HONEYCUTT (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HONEYCUTT
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3700 BARRETT DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7213
Mailing Address - Country:US
Mailing Address - Phone:919-231-3966
Mailing Address - Fax:919-231-3912
Practice Address - Street 1:790 SE CARY PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5678
Practice Address - Country:US
Practice Address - Phone:919-231-3966
Practice Address - Fax:919-231-3912
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC102565363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS66511Medicare UPIN
NC2748717AMedicare ID - Type UnspecifiedMEDICARE #