Individual
KATHRYN A O'DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
170 VILLAGE CENTER BLVD, MYRTLE BEACH, SC 29579-3400
(843) 449-5848
(843) 497-5019
Mailing address
170 VILLAGE CENTER BLVD, MYRTLE BEACH, SC 29579-3400
(843) 449-5848
(843) 497-5019
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
VP001864G
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0991970
KEYSTONE HEALTH PLAN CENT
PA
01
—
50038695
CAPITAL BLUE CROSS
PA
01
—
OD1629923
HIGHMARK
PA
Enumeration date
09/14/2005
Last updated
03/05/2020
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