Individual
DANA ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 E REDSTONE AVE STE 107, CRESTVIEW, FL 32539-5355
(850) 682-6320
(850) 682-6339
Mailing address
131 E REDSTONE AVE STE 107, CRESTVIEW, FL 32539-5355
(850) 682-6320
(850) 682-6339
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP9310065
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9310065
ARNP LISENSE
FL
Enumeration date
09/14/2016
Last updated
10/07/2016
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