| Doctor Name: | KELLIE M ODONNELL-STOCKTON |
| NPI Number: | 1033314976 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 2000172033 |
| Business Practice Address: | 201 Bjc Saint Peters Dr Suite 100 Saint Peters, MO - 633763091 |
| Business Phone Number: | 6369168200 |
| Business Fax Number: | 6369168239 |
| Mailing Address: | 201 Bjc Saint Peters Dr, Suite 100 SAINT PETERS |
| State: | MO |
| Postal Code: | 633763091 |
| Phone Number: | 6369168200 |
| Fax Number: | 6369168239 |
| NPI Enumeration Date: | 06/20/2007 |
| NPI Last Update Date: | 12/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2000172033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |