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Individual

CASEY O'DONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
55 HALLET ST, DORCHESTER, MA 02124-5407
(617) 288-6666
Mailing address
24 HEATHER RD, WATERTOWN, MA 02472-1706

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2279619
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN2279619
MA BOARD OF NURSING
MA
Enumeration date
03/02/2021
Last updated
03/02/2021
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