KIMBERLY A O'DONNELL ARNP NPI 1497273429

NPI Information

NPI: 1497273429
Provider Name: KIMBERLY A O'DONNELL, ARNP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: CANCER SPECIALISTS LLC

PECOS Registration: Yes

Address:
5742 BOOTH RD STE A
JACKSONVILLE, FL
ZIP 32207
Phone: (907) 739-7779
Get Directions

Kimberly A O'donnell, ARNP is an adult health nurse practitioner in Jacksonville, FL with 7 years of experience. Kimberly A O'donnell, ARNP NPI is 1497273429. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5742 BOOTH RD STE A
JACKSONVILLE, FL
ZIP 32207-982
Phone: (907) 739-7779
Fax: (904) 739-7771

The NPI 1497273429 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/30/2017 and was last updated on 1/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	APRN9297153	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P02352086	OTHER	FLORIDA	RAILROAD MEDICARE
2	022227700	MEDICAID	FLORIDA
3	5QPBY	OTHER	FLORIDA	FLORIDA BLUE
4	JC682Z	OTHER	FLORIDA	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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