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Individual
STACEY ELAINE ODDERA
Active
Individual
STACEY ELAINE ODDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209022361
IL
363LF0000X
Family Nurse Practitioner
Primary
277003734
IL
363LF0000X
Family Nurse Practitioner
3015488
KY
Other
Enumeration date
11/18/2020
Last updated
08/13/2026
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