Individual
MRS. KIMBERLEY HELEN ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1550 N CRESTMONT DRIVE, SUITE G, MERIDIAN, ID 83642
(208) 629-2023
(208) 759-5840
Mailing address
1550 N CRESTMONT DR STE G, MERIDIAN, ID 83642-2177
(208) 629-2023
(208) 759-5840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
68579
ID
Other
Enumeration date
04/25/2017
Last updated
06/20/2024
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