Odendahl, Keith Wayne
Odendahl, Keith Wayne is an individual health care provider with primary practice located at 7777 Hennessy Blvd Suite1000, Baton Rouge LA 70808-4300. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Odendahl, Keith Wayne can be contacted via phone (225) 767-3900.Contact Information
Primary practice address
7777 Hennessy Blvd Suite1000
Baton Rouge LA 70808-4300
Phone: (225) 767-3900
Fax: (225) 214-9109
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | AP03719 | Louisiana |
Profile Details
NPI number | 1811977846 |
---|---|
LBN Legal business name | Odendahl, Keith Wayne |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 17th, 2006 |
Last updated | Dec 16th, 2016 - about 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1811977846 | NPPES |
Louisiana | Other | P00712670 | RAILROAD MCARE THRU PEPA |
Louisiana | Other | 310063 | RAILROAD MCARE THRU PEPA |
Louisiana | MEDICAID | 1431940 | RAILROAD MCARE THRU PEPA |
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