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General NPI Number Information
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NPI Number | 1982123527
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Entity Type | Individual
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Provider Name | KIMBERLY ANNE O'DELL NP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 96 CAMPUS DR
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7163
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Country | US
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Telephone | 207-885-9905
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Fax |
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Provider Business Mailing Address
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Address Line | 181 CAMPGROUND RD
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City | ARUNDEL
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State | ME
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Zip | 04046-8307
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Country | US
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Telephone | 914-334-1111
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2324474
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP171176
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License Number State | ME
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