Individual
MS. BENEDICTA I ODEMERHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5800 GODFREY RD, FOBES 1525, GODFREY, IL 62035-2426
(618) 468-6800
(618) 468-7410
Mailing address
5800 GODFREY RD, GODFREY, IL 62035-2426
(618) 468-6800
(618) 468-7410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209009075
IL
363LF0000X
Family Nurse Practitioner
Primary
209009075
IL
Other
Enumeration date
10/03/2011
Last updated
05/05/2015
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