Provider Demographics
NPI:1699263566
Name:O'NEIL, KAITLYN MARIE (PAC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:MARIE
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:KAITKYN
Other - Middle Name:MARIE
Other - Last Name:PLOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:25 MONUMENT RD STE 290
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5073
Practice Address - Country:US
Practice Address - Phone:717-812-4090
Practice Address - Fax:717-812-4092
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant