Individual
JOHN ANDREW O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8820
(919) 350-7385
Mailing address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
206485
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
206485
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053876
—
NC
Enumeration date
07/27/2010
Last updated
04/09/2016
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