Basic Information
| Provider Information | |||||||||
| NPI: | 1104544659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'DONNELL | ||||||||
| FirstName: | ANGELA | ||||||||
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| Credential: | CNM, APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2545 W FRYE RD STE 5 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852246273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803213622 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9897 W MCDOWELL RD STE 320 | ||||||||
| Address2: | |||||||||
| City: | TOLLESON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853531625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808141910 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2022 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.