Provider Demographics
NPI:1407912314
Name:O'DONNELL, COLLEEN A (ARNP, RN-C)
Entity Type:Individual
Prefix:MISS
First Name:COLLEEN
Middle Name:A
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:ARNP, RN-C
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP RN C
Mailing Address - Street 1:4840 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1601
Mailing Address - Country:US
Mailing Address - Phone:913-491-6878
Mailing Address - Fax:913-491-6808
Practice Address - Street 1:4840 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1601
Practice Address - Country:US
Practice Address - Phone:913-491-6878
Practice Address - Fax:913-491-6808
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44348363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology