KATHRYN A O'DONALD CRNP NPI 1043205289

NPI Information

  • NPI: 1043205289
  • Provider Name: KATHRYN A O'DONALD, CRNP
  • Classification: Nurse Practitioner - 363LW0102X
  • Specialization: Women's Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 170 VILLAGE CENTER BLVD
    MYRTLE BEACH, SC
    ZIP 29579
  • Phone: (843) 449-5848

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NPI Details

Kathryn A O'donald, CRNP is a women's health nurse practitioner in Myrtle Beach, SC with 35 years of experience. Kathryn A O'donald, CRNP NPI is 1043205289. 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:

170 VILLAGE CENTER BLVD
MYRTLE BEACH, SC
ZIP 29579-400
Phone: (843) 449-5848
Fax: (843) 497-5019

The NPI 1043205289 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 9/14/2005 and was last updated on 3/5/2020.

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
1363LW0102XNurse PractitionerWomen's HealthVP001864GPENNSYLVANIAYes

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
10991970OTHERPENNSYLVANIAKEYSTONE HEALTH PLAN CENT
2OD1629923OTHERPENNSYLVANIAHIGHMARK
350038695OTHERPENNSYLVANIACAPITAL BLUE CROSS

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: 11/21/2025

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