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Individual

AMY REBECCA ODOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5955 AIRPORT BLVD, MOBILE, AL 36608-3135
(251) 633-0573
(251) 633-7367
Mailing address
PO BOX 7987, MOBILE, AL 36670-0987
(251) 633-0573

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1-140750
AL
363LG0600X
Gerontology Nurse Practitioner
Primary
1-140750
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05331824
MS
05
223807
AL
05
224261
AL
05
225017
AL
05
225084
AL
05
225622
AL
01
512-17400
BCBS OF AL
AL
01
512-17403
BCBS OF AL
AL
01
512-17404
BCBS OF AL
AL
01
512-17405
BCBS OF AL
AL
01
512-17406
BCBS OF AL
AL
01
6297709
AETNA
AL
01
630799312
HUMANA CHOICECARE
AL
01
6906123
UNITED HEALTHCARE
AL
01
A03845A
MEDICARE
AL
01
P02140037
RR MEDICARE
AL
01
Z54984
VIVA HEALTH
AL
Enumeration date
09/05/2018
Last updated
02/23/2024
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