Individual
MELISSA K ODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6294 STATE HIGHWAY 154, SESSER, IL 62884-2163
(618) 625-6979
(618) 625-6979
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2436
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041344692
IL
363L00000X
Nurse Practitioner
Primary
209.017951
IL
363LF0000X
Family Nurse Practitioner
209017951
IL
Other
Enumeration date
01/05/2012
Last updated
12/29/2022
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