Provider Demographics
NPI:1316591530
Name:ODLE, EMILY ELAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ELAINE
Last Name:ODLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELAINE
Other - Last Name:HOUSEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1136 ORCHARD WAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-6931
Mailing Address - Country:US
Mailing Address - Phone:530-720-4748
Mailing Address - Fax:
Practice Address - Street 1:3100 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0962
Practice Address - Country:US
Practice Address - Phone:530-342-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95096271163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse