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General NPI Number Information
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NPI Number | 1336836626
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Entity Type | Individual
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Provider Name | SYDNEY O'DONNELL
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Gender | Female
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 5 CONCOURSE PKWY FL 31
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-5350
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Country | US
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Telephone | 855-492-7642
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Fax |
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Provider Business Mailing Address
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Address Line | 585 MARSH PARK DR
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City | JOHNS CREEK
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State | GA
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Zip | 30097-6473
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Country | US
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Telephone | 404-625-0913
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN307106
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License Number State | GA
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