Individual
MRS. LANISSA DANIELLE ODOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2085 GOODMAN RD W, SUITE 50, HORN LAKE, MS 38637-1416
(662) 253-8459
(662) 253-8678
Mailing address
2085 GOODMAN RD W, SUITE 50, HORN LAKE, MS 38637-1416
(662) 253-8459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
17722
TN
363LF0000X
Family Nurse Practitioner
Primary
A810645
MS
Other
Enumeration date
07/27/2013
Last updated
12/30/2015
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