Individual
SANDRA ELAINE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 HIGHWAY 247, CASA, AR 72025-9700
(479) 330-0159
Mailing address
11 HIGHWAY 247, CASA, AR 72025-9700
(479) 330-0159
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A006138
AR
363LF0000X
Family Nurse Practitioner
Primary
A006138
AR
363LP2300X
Primary Care Nurse Practitioner
A006138
AR
Other
Enumeration date
03/26/2019
Last updated
03/20/2025
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