Provider Demographics
NPI:1306515093
Name:O'NEILL, ALICIA MARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MARIE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 ELM ST E
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:IA
Mailing Address - Zip Code:50469-1035
Mailing Address - Country:US
Mailing Address - Phone:641-372-0315
Mailing Address - Fax:
Practice Address - Street 1:705 ELM ST E
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:IA
Practice Address - Zip Code:50469-1035
Practice Address - Country:US
Practice Address - Phone:641-372-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165351207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine