Basic Information
| Provider Information | |||||||||
| NPI: | 1174560452 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'DAY | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 703 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SMETHPORT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167491147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148875838 | ||||||||
| FaxNumber: | 8143628695 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 INTERSTATE PKWY | ||||||||
| Address2: | BRADFORD REGIONAL MEDICAL CENTER | ||||||||
| City: | BRADFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167011036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143628674 | ||||||||
| FaxNumber: | 8143628695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN558938 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.