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Mark G Odden, CRNA

Nurse Anesthetist, Certified Registered in Manchester, IA. Individual provider (NPI-1).

NPI number1528022993
StatusActive
Last updated in NPPESNov 3, 2015

Details

NPI
1528022993
Entity type
Individual (NPI-1)
Name
Mr. Mark G Odden
Credential
CRNA
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 13, 2006
Last updated
Nov 3, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified RegisteredD-074818IAYes

Practice location

17893 224th St
Manchester, IA 52057-8629

Phone 563-927-6183 · Fax 563-927-6183

Mailing address

Po Box 359
Manchester, IA 52057-0359

Phone 563-927-7457 · Fax 563-927-7518

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