Provider Demographics
NPI:1871979583
Name:ODELL, NORMA JEAN
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:ODELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9762
Mailing Address - Country:US
Mailing Address - Phone:614-563-2615
Mailing Address - Fax:
Practice Address - Street 1:224 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9762
Practice Address - Country:US
Practice Address - Phone:614-563-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2599237376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide