Odom, Jennifer Nicole

Odom, Jennifer Nicole is an individual health care provider with primary practice located at 1613 N Mckenzie St , Foley AL 36535-2247. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Odom, Jennifer Nicole can be contacted via phone (251) 949-3710.

Contact Information

Primary practice address
1613 N Mckenzie St Foley AL 36535-2247
Phone: (251) 949-3710
Fax: (251) 949-3715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1-133663 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 1-133663 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1-133663 Alabama

Profile Details

NPI number 1255761938
LBN Legal business name Odom, Jennifer Nicole
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2013
Last updated Nov 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255761938 NPPES
Mississippi MEDICAID 03637799
Mississippi MEDICAID 7100681410
Mississippi MEDICAID 236578

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