Provider Demographics
NPI:1255307013
Name:O'DELL, ROBIN LEE (ARNP/CNM)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:O'DELL
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Gender:F
Credentials:ARNP/CNM
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Other - Credentials:
Mailing Address - Street 1:MADIGAN ARMY MEDICAL CENTER
Mailing Address - Street 2:9040 REID ST., ATTN: MCHJ-QCR
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-2252
Mailing Address - Fax:253-968-3278
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER
Practice Address - Street 2:9040 REID ST., ATTN: MCHJ-QCR
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:253-968-3278
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-04-25
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Provider Licenses
StateLicense IDTaxonomies
WAAP30005371367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife