Provider Demographics
NPI:1174952394
Name:O'NEAL, IVY (BSN, RN, OCN)
Entity type:Individual
Prefix:MRS
First Name:IVY
Middle Name:
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:BSN, RN, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3372
Mailing Address - Country:US
Mailing Address - Phone:740-689-6889
Mailing Address - Fax:740-687-8956
Practice Address - Street 1:401 N EWING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3372
Practice Address - Country:US
Practice Address - Phone:740-689-6889
Practice Address - Fax:740-687-8956
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH319609163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology