Provider Demographics
NPI:1750772364
Name:NYREE O'DONALD
Entity type:Organization
Organization Name:NYREE O'DONALD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NYREE
Authorized Official - Middle Name:D
Authorized Official - Last Name:O'DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-296-2204
Mailing Address - Street 1:674 LAKINS RD
Mailing Address - Street 2:
Mailing Address - City:STETSON
Mailing Address - State:ME
Mailing Address - Zip Code:04488-3610
Mailing Address - Country:US
Mailing Address - Phone:207-296-2204
Mailing Address - Fax:
Practice Address - Street 1:674 LAKINS RD
Practice Address - Street 2:
Practice Address - City:STETSON
Practice Address - State:ME
Practice Address - Zip Code:04488-3610
Practice Address - Country:US
Practice Address - Phone:207-296-2204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care