Provider Demographics
NPI:1740293455
Name:O'NEIL, ELIZABETH A (RN NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:ONEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN NP
Mailing Address - Street 1:502 N UNIVERSITY ST
Mailing Address - Street 2:JOHNSON HALL RM B5
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47907-2069
Mailing Address - Country:US
Mailing Address - Phone:765-494-6341
Mailing Address - Fax:765-496-1022
Practice Address - Street 1:502 N UNIVERSITY ST
Practice Address - Street 2:JOHNSON HALL RM B5
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2069
Practice Address - Country:US
Practice Address - Phone:765-494-6341
Practice Address - Fax:765-496-1022
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001686A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200527500Medicaid