Doctor Name: | MRS. CAROL BAKER O'LEARY |
NPI Number: | 1184627424 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, CS, NP-C |
License Number: | 0015000631 |
Business Practice Address: | 209 W Criser Rd Front Royal, VA - 226302360 |
Business Phone Number: | 5406362961 |
Business Fax Number: | 5406362933 |
Mailing Address: | 112 W North Ave, WINCHESTER |
State: | VA |
Postal Code: | 226013933 |
Phone Number: | 5406678187 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2005 |
NPI Last Update Date: | 01/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0809X |
License Number: | 0015000631 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Adult |
Taxonomy Definition: |