Provider Demographics
NPI:1881087948
Name:O'DONELL, RITA
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:O'DONELL
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 1:3457 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-3024
Mailing Address - Country:US
Mailing Address - Phone:484-707-9067
Mailing Address - Fax:484-241-4490
Practice Address - Street 1:3457 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-3024
Practice Address - Country:US
Practice Address - Phone:484-707-9067
Practice Address - Fax:484-241-4490
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN071864L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse