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General NPI Number Information
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NPI Number | 1235129925
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Entity Type | Individual
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Provider Name | KATHRYN ROBB O'DONNELL DO
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Gender | Female
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | BUILDING 808 GUNSTON ROAD
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City | FORT BELVOIR
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State | VA
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Zip | 22060-0001
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Country | US
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Telephone | 910-584-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 8525 CHASE GLEN CIR
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-3307
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Country | US
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Telephone | 910-584-1093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 200000796
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License Number State | NC
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