Individual
DANIELLE ELIZABETH O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 384-1067
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 384-1067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA2369
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100548670
—
KY
Enumeration date
06/19/2018
Last updated
01/02/2025
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