Sandra Elaine Odom
Nurse Practitioner, Family in Casa, AR. Individual provider (NPI-1).
NPI number1669933370
StatusActive
Last updated in NPPESMar 20, 2025
Details
- NPI
- 1669933370
- Entity type
- Individual (NPI-1)
- Name
- Sandra Elaine Odom
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 26, 2019
- Certification date
- Mar 20, 2025
- Last updated
- Mar 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | A006138 | AR | Yes |
| 363L00000X | Nurse Practitioner | A006138 | AR | |
| 363LP2300X | Nurse Practitioner, Primary Care | A006138 | AR |
Other names
- Sandra Patton (Former Name)
Practice location
11 Highway 247Casa, AR 72025-9700
Phone 479-330-0159
Mailing address
11 Highway 247Casa, AR 72025-9700
Phone 479-330-0159
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