Provider Demographics
NPI:1255192340
Name:ODINZOFF, CAROL ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ELIZABETH
Last Name:ODINZOFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 NASH CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3789
Mailing Address - Country:US
Mailing Address - Phone:907-360-7452
Mailing Address - Fax:877-211-6856
Practice Address - Street 1:2250 NASH CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3789
Practice Address - Country:US
Practice Address - Phone:907-360-7452
Practice Address - Fax:877-211-6856
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61390263163WC0400X
AKNURR13697163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management