Sharrell Tonya Odom, NP
Nurse Practitioner, Family in Ridgeway, SC. Individual provider (NPI-1).
NPI number1033453048
StatusActive
Last updated in NPPESJul 17, 2015
Details
- NPI
- 1033453048
- Entity type
- Individual (NPI-1)
- Name
- Sharrell Tonya Odom
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2012
- Last updated
- Jul 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 18080 | SC | Yes |
Practice location
755 Us Highway 21 SRidgeway, SC 29130-6844
Phone 803-337-2920 · Fax 803-337-3010
Mailing address
Po Box 3788Columbia, SC 29230-3788
Phone 803-733-5969 · Fax 803-753-5591
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