Provider Demographics
NPI:1891101168
Name:ODINA, PATIENCE (NP)
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:ODINA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7668B STANDISH PL STE 18
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2701
Mailing Address - Country:US
Mailing Address - Phone:301-920-7060
Mailing Address - Fax:240-366-5952
Practice Address - Street 1:7668B STANDISH PL
Practice Address - Street 2:SUITE #18
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2701
Practice Address - Country:US
Practice Address - Phone:301-920-7060
Practice Address - Fax:240-366-5952
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174233363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care