HOLLY NICOLE ODE (NPI# 1285153650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285153650 |
| Entity Type | Individual |
| Full Name | HOLLY NICOLE ODE |
| Credential | CPNP-PC |
| Practice Address |
4331 S Fremont Ave Springfield MO 65804-7328 |
| Mailing Address |
5501 Faust Ave Springfield MO 65810-3222 |
| Practice Telephone | (417) 820-5000 |
| Mailing Telephone | 4175699417 |
| Enumeration Date | 2017-09-16 |
| Last Update Date | 2017-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2017028239 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4331 S FREMONT AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-7328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144201369 | Mitchell Dean Hauschildt | Specialist/Technologist | 4331 S Fremont Ave, Healthtracks Sports Training Center, Springfield, MO 65804-7328 | 2005-11-07 |
| 1568094175 | Katie Primrose | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2020-02-11 |
| 1962042358 | Michael James Lane | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2020-01-13 |
| 1578038550 | Kelsey Kapella | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-10-05 |
| 1487134722 | Connor Parrish | Physical Medicine & Rehabilitation | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-16 |
| 1730669060 | Jessica M Jones | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-16 |
| 1619457207 | Derek Allen Clayton | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2018-08-14 |
| 1134640246 | Alexandra Jahnke | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-06-28 |
| 1972041358 | Ryinne A Jacquemin | Student in an Organized Health Care Education/Training Program | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-02-06 |
| 1396282885 | Kenna Daugherty | Specialist/Technologist | 4331 S Fremont Ave, Springfield, MO 65804-7328 | 2017-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568939684 | Katelyn Marie Reed | Nurse Practitioner | 415 N 9th St Ste 4w64, Springfield, IL 62702-5303 | 2018-10-26 |
| 1255813218 | Michelle Christine Bollinger | Nurse Practitioner | 415 N 9th St Ste 4w16, Springfield, IL 62702-5303 | 2018-09-05 |
| 1497205041 | Monica Hehir | Nurse Practitioner | 190 W Sproul Rd Ste 208, Springfield, PA 19064-2027 | 2016-10-06 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1023369774 | Elyssa N Rapier | Nurse Practitioner | 1901 S Ventura Ave, Suite B, Springfield, MO 65804-2700 | 2012-09-20 |
| 1033285192 | Kay Ann Froemming | Nurse Practitioner | 225 Q St, Springfield, OR 97477 | 2006-11-28 |
| 1982787115 | Christine Plumb | Nurse Practitioner | 280 Tinkham Rd, Springfield, MA 01129-1935 | 2006-10-23 |
| 1053429761 | Kimberly Jean Andrews | Nurse Practitioner | 1965 S Fremont, Ste 260, Springfield, MO 65804-2257 | 2006-08-25 |
| 1649249566 | Sherry M Dailey | Nurse Practitioner | 2073 Olympic Street, Riverstone Clinic, Springfield, OR 97477-3413 | 2006-03-14 |
| 1518941004 | Connie J Vargas | Nurse Practitioner | 471 Northcrest Dr, Springfield, TN 37172-3973 | 2005-11-30 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on HOLLY NICOLE ODE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.