Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC

Individual provider Family Nurse Practitioner · NPI 1881005478

Dr. Fatima Odetalla, DNP, FNP/PMHNP-BC is a Nurse Practitioner in Suffern, New York. Graduated from University of Tennessee, Hsc, College of Medicine in 2013, 13 years ago. Practices as a sole proprietor. Licensed in New York and Tennessee.

Years since qualifying
13
Trained at
University of Tennessee, Hsc, College of Medicine
Licensed in
NY, TN
In the registry since
2014
Specialties on file
4
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

65 E Maltbie Ave
Suffern, NY 10901-6007
Phone: (901) 590-7680
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F401694 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F338723 (NY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 18374 (TN)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 18374 (TN)

Record details

NPI number1881005478
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP , FNP/PMHNP-BC
Sole proprietorYes
NPI enumeratedMay 16, 2014
Last updated in NPPESNovember 17, 2020
Certification dateNovember 13, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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