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Katie Odom, FNP
Family Nurse Practitioner in Bloomsdale, Missouri
NPI 1194462010

Katie Odom is a Family Nurse Practitioner based in Bloomsdale, MO and is specialized in Family. Katie Odom practices in Bloomsdale, MO and has the professional credentials of FNP. The NPI Number for Katie Odom is 1194462010 and holds a License No. 2022009496 (Missouri).

The current practice location address for Katie Odom is 255 Boderman, Bloomsdale, MO and can be reached out via phone at 573-483-9492.

Location: 255 Boderman, Bloomsdale, MO, 63627-9099
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194462010
Provider Name
Katie Odom
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
255 Boderman, Bloomsdale, MO, 63627-9099
Phone Number
573-483-9492
Fax Number
Provider Enumeration Date
05/13/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2022009496 01 MO CNP LICENSE
institution
Provider Business Practice Location Address Details
Address
255 Boderman
City
Bloomsdale
State
Missouri
Zip
63627-9099
Phone Number
573-483-9492
Fax Number
person
Provider Business Mailing Address Details
Address
255 Boderman
City
Bloomsdale
State
Missouri
Zip
63627-9099
Phone Number
573-483-9492
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
2022009496 (Missouri)
Definition
Definition to come...
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