Provider Demographics
NPI:1740242908
Name:ODONNELL, CATHY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:ODONNELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061-0808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:603-595-2997
Practice Address - Street 1:4 DOBSON WAY
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4340
Practice Address - Country:US
Practice Address - Phone:603-424-4181
Practice Address - Fax:603-429-0335
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH023599-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30344100Medicare ID - Type Unspecified