Provider Demographics
NPI:1558585398
Name:O'DELL, KRISTEN ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:O'DELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:DYROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 624
Mailing Address - Street 2:
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922-0624
Mailing Address - Country:US
Mailing Address - Phone:845-220-6971
Mailing Address - Fax:
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:HUDSON VALLEY HOSPITAL, NICU
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:845-220-6971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-334645-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily