Provider Demographics
NPI:1497549620
Name:ODELL, AUBREY F
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:F
Last Name:ODELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10965 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:BURT
Mailing Address - State:MI
Mailing Address - Zip Code:48417-9630
Mailing Address - Country:US
Mailing Address - Phone:989-213-0797
Mailing Address - Fax:989-213-0797
Practice Address - Street 1:10965 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:BURT
Practice Address - State:MI
Practice Address - Zip Code:48417-9630
Practice Address - Country:US
Practice Address - Phone:989-213-0797
Practice Address - Fax:989-213-0797
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703130582164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse