Individual
MR. KYLE B O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA, PMHNP-BC
Contact information
Practice address
7474 GREENWAY CENTER DR, GREENBELT, MD 20770-3504
(203) 209-7108
Mailing address
636 NEWTON PL NW APT 203, WASHINGTON, DC 20010-1739
(203) 209-7108
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
125111
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R228913
MD
Other
Enumeration date
05/01/2017
Last updated
07/21/2022
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