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Individual

MRS. JACKIE RUTH O'DONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1606 PHYSICIANS DR, SUITE 103, WILMINGTON, NC 28401-7361
(910) 815-3994
(910) 815-3998
Mailing address
1606 PHYSICIANS DR, SUITE 103, WILMINGTON, NC 28401-7361
(910) 815-3994
(910) 815-3998

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN247313
OH

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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