Individual
JENNIFER LEA NICOLE O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
13861 MANCHESTER ROAD, TOWN AND COUNTRY, MO 63011
(636) 556-0114
(314) 270-3694
Mailing address
13861 MANCHESTER ROAD, TOWN AND COUNTRY, MO 63011
(636) 556-0114
(314) 270-3694
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2010028309
MO
363LF0000X
Family Nurse Practitioner
Primary
2018040236
MO
Other
Enumeration date
10/22/2018
Last updated
11/05/2018
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