Individual
ALEXANDRIA NICOLE ODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
70 N COUNTRY RD STE 105, PORT JEFFERSON, NY 11777-2161
(631) 642-0609
(631) 642-0588
Mailing address
70 N COUNTRY RD STE 105, PORT JEFFERSON, NY 11777-2161
(631) 642-0609
(631) 642-0588
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F35015-01
NY
363LF0000X
Family Nurse Practitioner
F350150
NY
Other
Enumeration date
10/04/2022
Last updated
10/16/2023
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