Individual
CHELSEA O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3 CHARLES ST, ELLENVILLE, NY 12428-2303
(845) 647-4502
Mailing address
PO BOX 414, MOUNTAIN DALE, NY 12763-0414
(845) 699-5976
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
322032
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BT60126Z
—
NY
Enumeration date
07/30/2018
Last updated
07/30/2018
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