National Provider Identifier

Odell Upshaw Jr.

Odell Upshaw Jr. is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 448-8539.

NPI 1174038046Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1174038046
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
December 13, 2017
Last Updated
December 13, 2017

Practice Location

  • 85 Meigs St Apt 1A
  • Rochester, NY 14607-2054

Phone: (585) 448-8539

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1174038046
Entity Type
Individual
Last Name
Upshaw
First Name
Odell
Name Suffix
Jr.
Mailing Street Address
85 Meigs St Apt 1A
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14607-2054
Mailing Country
US
Mailing Phone
(585) 448-8539
Practice Street Address
85 Meigs St Apt 1A
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14607-2054
Practice Country
US
Practice Phone
(585) 448-8539
Enumeration Date
December 13, 2017
Last Updated
December 13, 2017
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)