O'Donnell, Corianne L

O'Donnell, Corianne L is an individual health care provider with primary practice located at 103 Skyline Rd , Bangor ME 04401-2158. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. O'Donnell, Corianne L can be contacted via phone (610) 574-5628.

Contact Information

Primary practice address
103 Skyline Rd Bangor ME 04401-2158
Phone: (610) 574-5628
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1959 Massachusetts

Profile Details

NPI number 1548259211
LBN Legal business name O'Donnell, Corianne L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jan 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548259211 NPPES
Other 019590 CONNECTICARE
Other P00336251 CONNECTICARE

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