| NPI | 1821513052 |
|---|---|
| Former Name | KELLY ELISE O'NEILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8308) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2312879) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2021-04-07 |