Provider Demographics
NPI:1295072312
Name:O'DELL, MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:O'DELL
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:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-0970
Mailing Address - Country:US
Mailing Address - Phone:864-594-4440
Mailing Address - Fax:864-594-6145
Practice Address - Street 1:7 698 HOWARD STREET
Practice Address - Street 2:SPARTANBURG SCHOOL DISTRICT
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303
Practice Address - Country:US
Practice Address - Phone:864-594-4440
Practice Address - Fax:864-594-6145
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC992084163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool