Provider Demographics
NPI:1982301859
Name:OHARA, WILLIAM (PHMHNP-BC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:OHARA
Suffix:
Gender:M
Credentials:PHMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 W EPHESUS CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-2209
Mailing Address - Country:US
Mailing Address - Phone:480-980-7309
Mailing Address - Fax:
Practice Address - Street 1:2242 W EPHESUS CT
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-2209
Practice Address - Country:US
Practice Address - Phone:480-980-7309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ287014363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health