Doctor Name: | MS. EILEEN JOY ODONNELL |
NPI Number: | 1063412542 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, APRN |
License Number: | 000368 |
Business Practice Address: | 345 Montauk Ave New London, CT - 063204738 |
Business Phone Number: | 8604446711 |
Business Fax Number: | 8604370650 |
Mailing Address: | 146 Ironworks Rd, CLINTON |
State: | CT |
Postal Code: | 064131223 |
Phone Number: | 8606640466 |
Fax Number: | 8606693351 |
NPI Enumeration Date: | 07/27/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 000368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |