Individual
PATRICK KIRK O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
191 IOWA BLVD, TRENTON, MO 64683-8343
(816) 632-1390
Mailing address
511 W 4TH STREET TER, CARROLLTON, MO 64633-1420
(660) 322-5035
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017040279
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017040279
CERTIFIED NURSE PRACTITIONER
MO
Enumeration date
05/30/2019
Last updated
05/30/2019
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