Individual
KELCEY ODANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7400 W 132ND ST STE 120, OVERLAND PARK, KS 66213-1142
(620) 506-1647
Mailing address
108 N LOGAN ST, OLATHE, KS 66061-3131
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5382019052
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/28/2020
Last updated
07/26/2023
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