Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | NC |
NPI | 1235129925 |
---|---|
Provider Name | Dr. Kathryn Robb O'donnell |
First Address | Fayetteville, NC 28312-7228 |
Second Address | Fort Bragg, NC 28310-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 08/07/2007 |