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Mrs. Carly M Odesina, APRN
Family Nurse Practitioner in Portland, Connecticut
NPI 1548610959

Carly M Odesina is a Family Nurse Practitioner based in Middletown, CT and is specialized in Family. Carly M Odesina practices in Portland, CT and has the professional credentials of APRN. The NPI Number for Carly M Odesina is 1548610959 and holds a License No. 12.006642 (Connecticut).

The current practice location address for Carly M Odesina is 270 Main St, Portland, CT and can be reached out via phone at 860-342-3392 and via fax at 860-358-8658.

Location: 270 Main St, Portland, CT, 06457-3654
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548610959
Provider Name
Carly M Odesina
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
270 Main St, Portland, CT, 06457-3654
Phone Number
860-342-3392
Fax Number
860-358-8658
Provider Enumeration Date
06/16/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
008067661 05 CT
institution
Provider Business Practice Location Address Details
Address
270 Main St
City
Portland
State
Connecticut
Zip
06480-1836
Phone Number
860-342-3392
Fax Number
860-358-8658
person
Provider Business Mailing Address Details
Address
270 Main St
City
Portland
State
Connecticut
Zip
06480-1836
Phone Number
860-342-3392
Fax Number
860-358-8658
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
12.006642 (Connecticut)
Definition
Definition to come...
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