Individual
SHANDA ODOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-5000
Mailing address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-5000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R858081
MS
Other
Enumeration date
10/17/2014
Last updated
09/30/2016
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