Healthcare Provider Details

I. General information

NPI: 1598637639
Provider Name (Legal Business Name): LORRAINE ODANGO MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

2639 LAKE DEVIN RD
OXFORD NC
27565-8586
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-3141
  • Fax:
Mailing address:
  • Phone: 510-418-0495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number340590
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: