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Individual

KATIE ODOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1106 HAZEL LN, FARMINGTON, MO 63640-1999
(573) 756-6751
(573) 760-8044
Mailing address
PO BOX 957683, SAINT LOUIS, MO 63195-9099
(573) 756-6751
(573) 760-8044

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2022009496
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2022009496
CNP LICENSE
MO
Enumeration date
05/13/2022
Last updated
09/18/2025
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