Individual
MRS. JENNIFER NICOLE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3710
(251) 949-3715
Mailing address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3479
(251) 949-3434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-133663
AL
363LA2100X
Acute Care Nurse Practitioner
Primary
1-133663
AL
363LF0000X
Family Nurse Practitioner
1-133663
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03637799
—
MS
05
—
236578
—
AL
05
—
7100681410
—
KY
Enumeration date
11/18/2013
Last updated
11/10/2023
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