Individual
KATELYNN S O'DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2410 RING RD STE 500, ELIZABETHTOWN, KY 42701-7991
(502) 559-3636
(270) 769-0931
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 559-9378
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3017238
KY
363LP2300X
Primary Care Nurse Practitioner
3017238
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300062101
—
IN
Enumeration date
01/18/2022
Last updated
10/14/2024
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