Provider Demographics
NPI:1033532098
Name:ODER, JODI (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:ODER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-3211
Mailing Address - Country:US
Mailing Address - Phone:620-332-3280
Mailing Address - Fax:
Practice Address - Street 1:800 W LAUREL ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3211
Practice Address - Country:US
Practice Address - Phone:620-332-3280
Practice Address - Fax:620-332-3281
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily