Healthcare Provider Details

I. General information

NPI: 1992616080
Provider Name (Legal Business Name): SABRINA ODEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 CLEVELAND AVE
COLUMBUS OH
43211-2273
US

IV. Provider business mailing address

3982 POWELL RD
POWELL OH
43065-7662
US

V. Phone/Fax

Practice location:
  • Phone: 614-354-5569
  • Fax:
Mailing address:
  • Phone: 614-354-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number177748
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: