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Individual

CYNTHIA C. ODOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, FNP

Contact information

Practice address
920 MATTHEW DR, WAYNESBORO, MS 39367-2553
(601) 735-2401
(601) 735-5205
Mailing address
PO BOX 1249, WAYNESBORO, MS 39367-1249
(601) 735-2401
(601) 735-5205

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R748528
MS
367A00000X
Advanced Practice Midwife
Primary
R748528
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00116409
MS
05
569900143
AL
01
730-19137
BCBS OF AL
AL
Enumeration date
11/22/2005
Last updated
04/24/2017
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