Individual
DR. NICOLE RACHEL O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, CPNP-AC
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 289-5019
Mailing address
9233 W 100TH AVE, SAINT JOHN, IN 46373-8014
(708) 289-5019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2009022174
MO
363L00000X
Nurse Practitioner
Primary
277002111
IL
363L00000X
Nurse Practitioner
71013468A
IN
363LP0222X
Critical Care Pediatric Nurse Practitioner
2018028919
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018028919
NATIONAL COUNCIL OF STATE BOARDS OF NURSING
MO
01
—
20186482
PEDIATRIC NURSING CERTIFICATION BOARD
—
Enumeration date
03/14/2019
Last updated
03/01/2023
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