| NPI | 1578456299 |
|---|---|
| Other Name | JACK D O'CONNELL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP70035316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61326168) |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-10-14 |