# COLLEEN ODONNELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1942290804
- **Gender:** F
- **Credential:** P.A.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 007859-1 | NY | — |
| 363AS0400X | Surgical Physician Assistant | 6526009-1206 | UT | Yes |

## Other

- **Enumeration date:** 10/24/2005
- **Last updated:** 03/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02108996 | — | NY |