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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 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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