Provider Demographics
NPI:1285917716
Name:O'NEIL, WILMA CHARLENE (PHARM D, RP)
Entity type:Individual
Prefix:MS
First Name:WILMA
Middle Name:CHARLENE
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:PHARM D, RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 S LEMAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3251
Mailing Address - Country:US
Mailing Address - Phone:970-482-5492
Mailing Address - Fax:
Practice Address - Street 1:743 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3251
Practice Address - Country:US
Practice Address - Phone:970-482-5492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17566183500000X
NE10516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist