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General NPI Number Information
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NPI Number | 1427578368
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Entity Type | Individual
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Provider Name | JAYSON JOHN O'DONNELL RN
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Gender | Male
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 347 N KUAKINI ST
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City | HONOLULU
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State | HI
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Zip | 96817-2336
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Country | US
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Telephone | 808-587-3425
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Fax | 808-587-3430
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Provider Business Mailing Address
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Address Line | 3311 CAMPBELL AVE
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City | HONOLULU
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State | HI
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Zip | 96815-3808
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Country | US
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Telephone | 808-349-4895
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN-86082
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License Number State | HI
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