Provider Demographics
NPI:1932768199
Name:O'NEILL, COURTNEY KIRBY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:KIRBY
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WASHINGTON HEIGHTS MED CTR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5632
Mailing Address - Country:US
Mailing Address - Phone:410-848-5450
Mailing Address - Fax:
Practice Address - Street 1:215 WASHINGTON HEIGHTS MED CTR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5632
Practice Address - Country:US
Practice Address - Phone:410-848-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170128363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology