Odom, Sharrell Tonya

Odom, Sharrell Tonya is an individual health care provider with primary practice located at 755 Us Highway 21 S , Ridgeway SC 29130-6844. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Odom, Sharrell Tonya can be contacted via phone (803) 337-2920.

Contact Information

Primary practice address
755 Us Highway 21 S Ridgeway SC 29130-6844
Phone: (803) 337-2920
Fax: (803) 337-3010
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 18080 South Carolina

Profile Details

NPI number 1033453048
LBN Legal business name Odom, Sharrell Tonya
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2012
Last updated Jul 17th, 2015 - about 10 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 1033453048 NPPES
South Carolina MEDICAID NP2358

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