Healthcare Provider Details
I. General information
NPI: 1811237415
Provider Name (Legal Business Name): DONNA L O'DANIEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/20/2013
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
55 N MILFORD DR
FRANKLIN IN
46131-7308
US
IV. Provider business mailing address
11 TRAFALGAR SQ
TRAFALGAR IN
46181-9515
US
V. Phone/Fax
- Phone: 317-739-4848
- Fax: 317-346-4062
- Phone: 317-680-9103
- Fax: 317-878-2355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 08003458A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 71004337A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 1811237415 |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: