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General NPI Number Information
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NPI Number | 1740519602
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Entity Type | Individual
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Provider Name | CHANNIE LATAURUS ODAMS LPN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2009
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 40075 EATON ST APT 203
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City | CANTON
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State | MI
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Zip | 48187-4526
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Country | US
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Telephone | 734-521-1577
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Fax |
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Provider Business Mailing Address
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Address Line | 847 SUMPTER ROAD #436
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City | BELLEVILLE
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State | MI
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Zip | 48111
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Country | US
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Telephone | 734-851-1577
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 71594
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN090950
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 3747A0650X
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703101060
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License Number State | MI
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