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General NPI Number Information
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NPI Number | 1649818469
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Entity Type | Individual
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Provider Name | DINAH LEE O'DELL
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Gender | Female
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 17447 CAREY RD
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City | WESTFIELD
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State | IN
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Zip | 46074-9439
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Country | US
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Telephone | 317-896-3022
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Fax | 317-867-3155
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Provider Business Mailing Address
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Address Line | 17447 CAREY RD
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City | WESTFIELD
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State | IN
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Zip | 46074-9439
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Country | US
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Telephone | 317-896-3022
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Fax | 317-867-3155
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26016054
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License Number State | IN
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