Individual
EGHOSA ODOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6900 PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
903 SHAFTOE ST NW, KENNESAW, GA 30152-6999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN201454
GA
Other
Enumeration date
06/05/2014
Last updated
06/11/2014
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