COLLEEN ODONNELL (NPI# 1942290804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942290804 |
| Entity Type | Individual |
| Full Name | COLLEEN ODONNELL |
| Credential | P.A. |
| Practice Address |
2132 N 1700 W Ste 230 Layton UT 84041-7060 |
| Mailing Address |
4017 N Wolf Creek Dr Eden UT 84310-9894 |
| Practice Telephone | 8017733900 |
| Practice Fax Number | 8017733900 |
| Mailing Telephone | 8016906456 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 007859-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
6526009-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02108996 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1407 N 2000 W Ste F, Clinton, UT 840158563 | 8017733900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1164952024 | Colleen Casey Odonnell | Pharmacist | 2181 Pelham Pkwy, Pelham, AL 35124-1119 | 2017-06-14 |
| Street Address |
2132 N 1700 W STE 230 |
| City | LAYTON |
| State | UT |
| Zip Code | 84041-7060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225129158 | Brent Thomas Watson | Orthopaedic Surgery | 2132 N 1700 W Ste 230, Layton, UT 84041-7060 | 2006-09-27 |
| 1336128388 | Dallin L Demordaunt | Physical Medicine & Rehabilitation | 2132 N 1700 W Ste 230, Layton, UT 84041-7060 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
| 1154961399 | Victoria Leeann Taylor | Massage Therapist | 716 Antelope Dr, Layton, UT 84041 | 2020-01-15 |
| 1184181505 | Brian Taylor Woodbury | Occupational Therapist | 471 Heritage Park Blvd. Ste #5, Layton, UT 84041 | 2019-02-21 |
| 1740756816 | Jacob C Juarez | Physician Assistant | 2084 N. 1700 W., Suite A, Layton, UT 84041 | 2018-10-16 |
| 1134637945 | Jodi Lynn Siri | Counselor | 365 W 1550 N Ste F, Layton, UT 84041 | 2018-01-15 |
| 1083128029 | Utah Cvs Pharmacy LLC | Pharmacy | 50 South Fort Lane, Layton, UT 84041 | 2017-11-29 |
| 1376057315 | Utah Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 W & W 1700 S Nec, Layton, UT 84041 | 2017-11-29 |
| 1912411992 | Live Strong House LLC | Counselor | 377 N. Marshall Way, Suite 1b, Layton, UT 84041 | 2017-11-28 |
| 1003326505 | Kenneth L Ernstrom | Pharmacist | 2065 N Robins Drive, Layton, UT 84041 | 2017-10-10 |
| 1356868319 | Utah Home Health and Hospice LLC | Family Medicine | 920 W Heritage Park Blvd Suite 120, Layton, UT 84041 | 2017-08-29 |
| Find all providers in zip 84041 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336493709 | Monica L Hatch | Physician Assistant | 2132 N 1700 W Ste 200, Layton, UT 84041-7060 | 2012-11-06 |
| 1881790095 | Aaron Butcher | Physician Assistant | 1660 W Antelope Dr Ste 225, Layton, UT 84041-1167 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649892829 | Van Martin Stonehocker | Physician Assistant | 755 W Center St, Orem, UT 84057-5365 | 2020-05-11 |
| 1366004517 | Brock Bodily | Physician Assistant | 10623 S Redwood Rd # 101, South Jordan, UT 84095-2481 | 2019-07-08 |
| 1891230041 | Sarah Danielle Mendenhall | Physician Assistant | 5169 S Cottonwood St Ste 600, Murray, UT 84107-6771 | 2016-12-26 |
| 1104284124 | Amanda Cummings | Physician Assistant | 30 N 1900 E # 3b110, Salt Lake City, UT 84132-0002 | 2016-02-04 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1861895344 | Ariel Black | Physician Assistant | 30 N 1900 E # 3c344, Salt Lake City, UT 84132-0002 | 2014-09-29 |
| 1912130311 | Andrew M Strong | Physician Assistant | 5323 Woodrow St Ste 202, Salt Lake City, UT 84107-5848 | 2009-09-01 |
| 1164666061 | Stephen A Loper | Physician Assistant | 1055 N 500 W Ste 211, Provo, UT 84604-3305 | 2009-04-23 |
| 1982869210 | Scott D Taylor | Physician Assistant | 5323 Woodrow St Ste 102, Murray, UT 84107-5853 | 2008-07-25 |
| 1255517488 | William R. Mathie | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2008-01-17 |
| Find all providers with the same taxonomy | ||||
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| 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.