Individual
BRYAN O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3007581
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072164
—
OH
05
—
3810024645
—
WV
05
—
7100230920
—
KY
Enumeration date
09/12/2012
Last updated
01/09/2022
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