Provider Demographics
NPI:1568521060
Name:O'DONNELL, LINDA (WHNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PARTRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6595
Mailing Address - Country:US
Mailing Address - Phone:478-953-5334
Mailing Address - Fax:
Practice Address - Street 1:1109 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2022
Practice Address - Country:US
Practice Address - Phone:229-430-4572
Practice Address - Fax:229-430-3088
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN104516363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health