Provider Demographics
NPI:1053919845
Name:O'NEILL, KRISTIN LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 ORR RD
Mailing Address - Street 2:
Mailing Address - City:LUCAS
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8847
Mailing Address - Country:US
Mailing Address - Phone:806-224-8610
Mailing Address - Fax:
Practice Address - Street 1:3600 FM 407 E
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226-9728
Practice Address - Country:US
Practice Address - Phone:940-220-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09200862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily