Individual
MRS. ROXIAN H ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1776 HIGHWAY 49 S, FLORENCE, MS 39073-9429
(601) 825-6010
(601) 825-7146
Mailing address
110 TURKEY HOLW, TERRY, MS 39170-9104
(601) 618-6000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903462
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07230211
—
MS
Enumeration date
07/26/2019
Last updated
10/13/2022
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