Nicole Lyn O'Neill
Individual provider Active NPI Physical Therapist · Rockford, MN
NPI 1619563178 · NPPES record last updated Dec 17, 2020
Key facts
- NPI
- 1619563178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11994 (MN)
- Practice address
- 6050 Main St Apt 101
Rockford, MN 55373-4537 - Phone
- (763) 515-3088
- NPI assigned
- Dec 17, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11994 | MN | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11994 | MN | Yes |
Addresses
Primary practice location
6050 Main St Apt 101
Rockford, MN 55373-4537
Mailing address
401 Sigrid Dr
Buffalo, MN 55313-1259
Phone (763) 688-0660
Other providers in Rockford, MN
- Krull Health & Wellness, PLLC
- Joy Kwai-Lyn Langenburg
- Joseph Gerard Lynch
- Gladys Kerubo Machogu
- Stacy Nathan
- Cheyne Summer Page
- Amy Beth Pederson
- Thomas Ervin Peterson
- Sarah Prestegard
- Provisional Home Health LLC
All providers in Rockford, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.