Provider Demographics
NPI:1689495756
Name:O'DELL, COMFORT AKUBA (RN)
Entity type:Individual
Prefix:
First Name:COMFORT
Middle Name:AKUBA
Last Name:O'DELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MENDON RD UNIT 31
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6229
Mailing Address - Country:US
Mailing Address - Phone:781-234-5988
Mailing Address - Fax:
Practice Address - Street 1:500 MENDON RD UNIT 31
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-6229
Practice Address - Country:US
Practice Address - Phone:781-234-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2295537163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Single Specialty