Individual
SARA R ODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202-5700
(502) 583-8303
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 559-9257
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1118146
KY
363L00000X
Nurse Practitioner
Primary
3007997
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201174260
—
IN
01
—
50049829
PASSPORT
KY
05
—
7100247870
—
KY
Enumeration date
03/04/2013
Last updated
05/29/2024
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