Individual
MARYELLEN THERESA O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
250 KING OF PRUSSIA RD, RADNOR, PA 19087-5220
(610) 902-5625
Mailing address
250 KING OF PRUSSIA RD, RADNOR, PA 19087-5220
(610) 902-5625
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
VP006835C
PA
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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