Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 50968-20 | WI |
Y | 207V00000X | Obstetrician & Gynecologist | 52019 | MN |
NPI | 1023067204 |
---|---|
Provider Name | Ann M. O'donnell |
First Address | Bloomington, MN 55425-4516 |
Second Address | Shakopee, MN 55379-3374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 09/03/2021 |