| Doctor Name: | SHANNA O'DONNELL |
| NPI Number: | 1609887439 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 686322 |
| Business Practice Address: | 1200 North Virginia Port Lavaca, TX - 77979 |
| Business Phone Number: | 3615526721 |
| Business Fax Number: | 3615527463 |
| Mailing Address: | 1200 N Virginia St, PORT LAVACA |
| State: | TX |
| Postal Code: | 779792507 |
| Phone Number: | 3615526721 |
| Fax Number: | 3615527463 |
| NPI Enumeration Date: | 08/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 686322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |