KATHLEEN O'DEA NPI 1588673818

NPI Information

NPI: 1588673818
Provider Name: KATHLEEN O'DEA
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
525 PORTLAND AVE
MC: 952
MINNEAPOLIS, MN
ZIP 55415
Phone: (612) 348-9840
Get Directions

Kathleen O'dea is a pediatrics nurse practitioner in Minneapolis, MN. Kathleen O'dea NPI is 1588673818. 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:

525 PORTLAND AVE
MC: 952
MINNEAPOLIS, MN
ZIP 55415-533
Phone: (612) 348-9840
Fax: (612) 596-7900

The enumeration date for this NPI number is 8/5/2006 and was last updated on 4/15/2013.

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	363LP0200X	Nurse Practitioner	Pediatrics	R 062385-6	MINNESOTA	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	6982979	OTHER	MINNESOTA	EVERCARE
2	718015200	MEDICAID	MINNESOTA
3	1200207	OTHER	MINNESOTA	MEDICA
4	500000908	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
5	HP21019	OTHER	MINNESOTA	HEALTHPARTNERS

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »