Healthcare Provider Details

I. General information

NPI: 1801102140
Provider Name (Legal Business Name): JOSEPHINE N ODUME FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176E MOSHOLU PKWY S OFFICE OF DR. PLUMMER
BRONX NY
10458
US

IV. Provider business mailing address

74 BELMONT AVE
YONKERS NY
10704-2840
US

V. Phone/Fax

Practice location:
  • Phone: 718-367-6100
  • Fax: 718-733-4020
Mailing address:
  • Phone: 646-285-8386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number571288
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF338483-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: