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1558964080
STACEY ELAINE ODDERA
ANNA, IL
NPI
1558964080
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209022361)
Enumeration Date
2020-11-18
Last Update Date
2023-10-19
Business Address
STACEY ELAINE ODDERA APRN
98 PEACH RIDGE RD
ANNA, IL 62906-2243
Phone number: 618-614-1400
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Mailing Address
STACEY ELAINE ODDERA APRN
PO BOX 3988
CARBONDALE, IL 62902-3988
Phone number: 618-457-5200
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