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Individual

CARLIE O'MEARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
306 SPOTTED RIDGE CIR, WOODSTOCK, GA 30188-2625
(203) 650-1162
Mailing address
203 BETHANY CREEK BND, WOODSTOCK, GA 30188-3339
(203) 650-1162

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN314370
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33568332
PA
Enumeration date
08/17/2022
Last updated
08/17/2022
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