ODETTE AMANDA PRINCE (NPI# 1669906228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669906228 |
| Entity Type | Individual |
| Full Name | ODETTE AMANDA PRINCE |
| Credential | RN |
| Practice Address |
110 Evans Mill Dr Dallas GA 30157-1622 |
| Mailing Address |
1113 Willow Field Ln Se Marietta GA 30067-3942 |
| Practice Telephone | 4046530374 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN255982 | GA | Nursing Service Providers |
| N | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
RN255982 | GA | Nursing Service Providers |
| Y | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
RN255982 | GA | Nursing Service Providers |
| Street Address |
110 EVANS MILL DR |
| City | DALLAS |
| State | GA |
| Zip Code | 30157-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184795080 | Mark Stephen Wolfe | Marriage & Family Therapist | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2006-11-13 |
| 1851836597 | Second Chance Or More Counseling Services | Community/Behavioral Health | 110 Evans Mill Dr, Suite 401, Dallas, GA 30157-1622 | 2017-01-05 |
| 1780032490 | Warren Smith | Chiropractor | 110 Evans Mill Dr, Suite 301, Dallas, GA 30157-1622 | 2016-06-03 |
| 1669820379 | Precision Chiropractic Corporation | Chiropractor | 110 Evans Mill Dr, Suie 301, Dallas, GA 30157-1622 | 2016-06-03 |
| 1245612191 | Ironwood Counseling LLC | Counselor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2015-06-26 |
| 1215338652 | Diana Keys | Counselor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2014-09-04 |
| 1316376890 | Kimdi Joy Fair | Chiropractor | 110 Evans Mill Dr, Suite 105, Dallas, GA 30157-1622 | 2013-11-05 |
| 1093144768 | Jeffrey Kilheffer | Chiropractor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2013-11-04 |
| 1255767232 | Jno, Inc. | In Home Supportive Care | 110 Evans Mill Dr, Suite 801, Dallas, GA 30157-1622 | 2013-09-23 |
| 1447595806 | Lthw Surgical, LLC | Surgery | 110 Evans Mill Dr, Suite 401, Dallas, GA 30157-1622 | 2012-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608629 | Harshadbhai Vinubhai Patel | Pharmacist | 3615 Marietta Highway, Dallas, GA 30157 | 2020-10-30 |
| 1043852627 | Lindsay Sheets | Dentist | 59 Hillside Trce Ste 105, Dallas, GA 30157 | 2019-10-15 |
| 1619459062 | Emily Nicole Koopman | Specialist/Technologist | 399 Powder Creek Way, Dallas, GA 30157 | 2018-09-02 |
| 1073969861 | Rachel Spencer | Physical Therapist | 99 Hillside Trace, Dallas, GA 30157 | 2016-05-11 |
| 1336514827 | Petal Shields | Community Health Worker | 121 Omega Ct, Dallas, GA 30157 | 2015-12-09 |
| 1851797294 | Annette Moncion | Nurse Practitioner | 32 Midland Lane, Dallas, GA 30157 | 2014-11-12 |
| 1003211079 | Melissa Brice | Lactation Consultant, Non-RN | 430 Parson Rd, Dallas, GA 30157 | 2014-11-03 |
| 1104101690 | Jared Alan Lott | Pharmacist | 303 Charlie Watts Blvd, Dallas, GA 30157 | 2011-10-15 |
| 1972888758 | Lisa Nicole Mcentire | Massage Therapist | 119 Fairview Oak Trace, Dallas, GA 30157 | 2011-10-12 |
| 1548570120 | Chad Stough | Physician Assistant | 2713 Marietta Highway, Suite 122, Dallas, GA 30157 | 2010-10-15 |
| Find all providers in zip 30157 | ||||
| Taxonomy Code | 163WP0807X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Child & Adolescent |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053533950 | Donna Greenman | Registered Nurse | 2600 N Stemmon Ste 151, Dallas, TX 75207 | 2007-05-02 |
| 1457838286 | Ronita Khan | Registered Nurse | 1409 S Lamar St Apt 307, Dallas, TX 75215-6819 | 2018-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851877013 | Aurelia Linda Bryant-moody | Registered Nurse | 2012 Eastview Pkwy Ste 400, Conyers, GA 30013-5701 | 2018-07-11 |
| 1902349145 | Erica Steed | Registered Nurse | 3270 Cape Cir, Alpharetta, GA 30009-3772 | 2016-11-21 |
| 1821344557 | Nellie Idara Samuel | Registered Nurse | 2400 Northside Xing, Macon, GA 31210-2252 | 2012-07-31 |
| 1720340078 | Linda D Ilesanmi | Registered Nurse | 4045 George Busbee Pkwy Nw, Kennesaw, GA 30144-4894 | 2012-06-12 |
| 1386910438 | Thomas L Myers | Registered Nurse | 644 Shannon Way, Lawrenceville, GA 30044-6305 | 2012-03-22 |
| 1073889143 | Maureen U Anyaoha | Registered Nurse | 1410 Paddocks Way, Powder Springs, GA 30127-5500 | 2012-03-22 |
| 1780959106 | Barbara Elaine Hill-coatney | Registered Nurse | 1358 Thomas Rd, Decatur, GA 30030-4621 | 2012-03-19 |
| 1740554799 | Lanalynne Ann Kurtzworth | Registered Nurse | 35 Beranda Cir, Douglasville, GA 30134-4626 | 2012-03-07 |
| 1659668622 | Willie C Onyilo | Registered Nurse | 3126 Esplanade Cir Sw, Atlanta, GA 30311-4221 | 2011-06-29 |
| 1124314232 | Philomen Anabelle Mcfee | Registered Nurse | 225 Johnson Rd, 45e, Forest Park, GA 30297-2861 | 2011-06-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ODETTE AMANDA PRINCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.