Provider Demographics
NPI:1407652365
Name:ODELL, MINDY SUE
Entity type:Individual
Prefix:MS
First Name:MINDY
Middle Name:SUE
Last Name:ODELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-1412
Mailing Address - Country:US
Mailing Address - Phone:402-367-8460
Mailing Address - Fax:
Practice Address - Street 1:730 N 7TH ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-1412
Practice Address - Country:US
Practice Address - Phone:402-367-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion