| NPI | 1952875734 | 
|---|---|
| Former Name | KIMBERLY L O'DELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008676A)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28199727A)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28199727A)  | |
| Enumeration Date | 2019-01-15 | 
| Last Update Date | 2025-02-12 |