Most Relevant Information
Provider Data
| NPI Number: | 1003574294 |
| Provider Name: | STACEY LYNN ODELL RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WH0500X |
| Specialty: | Registered Nurse |
| License Number: | RN40785 |
Most Important Dates
| Enumeration Date: | 12/04/2021 |
| Last Updated: | 12/04/2021 |
Provider Practice Location
60 DOGWOOD DR APT 302
WEST WARWICK
RI
028937541
Practice Location Phone/Fax
| Phone: | 4012251605 |
| Fax: |
Provider Mailing Location
60 DOGWOOD DR APT 302
WEST WARWICK
RI
028937541
Provider Mailing Phone/Fax
| Phone: | 4012251605 |
| Fax: |