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Individual

RILEY ODOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2000
Mailing address
2318 TAFT ST NE, MINNEAPOLIS, MN 55418-4132

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
5737
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/19/2018
Last updated
03/22/2018
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