MEDICARE: EMILY ROSE O'DELL CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	002464	NY

General Provider Information

NPI Number	:	1922950047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ROSE O'DELL CNM

Provider Business Mailing Address
First Line	:	138 DECATUR ST APT 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2512
Country	:	US
Telephone Number	:	410-564-4799
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 DECATUR ST APT 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2512
Country	:	US
Telephone Number	:	410-564-4799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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