Provider Demographics
NPI:1487979662
Name:ODELL, ANNE PATRICIA (PHD, FNP-C, APRN)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:PATRICIA
Last Name:ODELL
Suffix:
Gender:F
Credentials:PHD, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 63RD PL # 9
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5692
Mailing Address - Country:US
Mailing Address - Phone:626-841-8328
Mailing Address - Fax:562-434-0388
Practice Address - Street 1:99 63RD PL #9
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5692
Practice Address - Country:US
Practice Address - Phone:626-841-8328
Practice Address - Fax:562-434-0388
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily