Provider Demographics
NPI:1871572024
Name:O'NEIL, KAREN ANNE (APRN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANNE
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SE OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2114
Mailing Address - Country:US
Mailing Address - Phone:772-337-7676
Mailing Address - Fax:772-337-7876
Practice Address - Street 1:111 SE OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2114
Practice Address - Country:US
Practice Address - Phone:772-337-7676
Practice Address - Fax:772-337-7876
Is Sole Proprietor?:No
Enumeration Date:2006-01-15
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1820922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY04Y3OtherBCBS OF FLORIDA
FL002791300Medicaid
FLAD757XMedicare PIN
FLY04Y3OtherBCBS OF FLORIDA