Provider Demographics
NPI:1831851021
Name:O'NEILL, AMY JO (APRN, CRNP-PMH)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JO
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:APRN, CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 CONTINENTAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2304
Mailing Address - Country:US
Mailing Address - Phone:443-987-1360
Mailing Address - Fax:443-987-1360
Practice Address - Street 1:5022 CAMPBELL BLVD STE L-M
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4969
Practice Address - Country:US
Practice Address - Phone:443-442-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1675882084P0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry