HOLLY KAYLENE ODOM (NPI# 1790392850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790392850 |
| Entity Type | Individual |
| Full Name | HOLLY KAYLENE ODOM |
| Credential | FNP |
| Practice Address |
5909 U S Highway 49 Ste 20 Hattiesburg MS 39402-2860 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012962800 |
| Practice Fax Number | 6012962802 |
| Mailing Telephone | 6012962800 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2020-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 903803 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5909 U S HIGHWAY 49 STE 20 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-2860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316390289 | Jenisus Marie Owens | Family Medicine | 5909 U S Highway 49 Ste 20, Hattiesburg, MS 39402-2860 | 2016-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427517770 | Tiffanie Suzanne Bellino | Nurse Practitioner | 751 Harold Tucker Rd, Hattiesburg, MS 39401-9529 | 2019-03-17 |
| 1790284222 | Gaynell Galt Martin | Nurse Practitioner | 1 Lincoln Pkwy Ste 106, Hattiesburg, MS 39402-3261 | 2018-02-10 |
| 1831597202 | Markus Dick Craig | Nurse Practitioner | 82 Serene Hills, Hattiesburg, MS 39402 | 2014-12-16 |
| 1104243195 | Marcie Lee | Nurse Practitioner | 51 Brooks Rd, Hattiesburg, MS 39401-8927 | 2014-03-27 |
| 1013258524 | Planned Parenthood Southeast, Inc. | Nurse Practitioner | 214 S 27th Ave, Hattiesburg, MS 39401-7165 | 2013-03-07 |
| 1699064659 | John E. Marsh | Nurse Practitioner | 1 Lincoln Pkwy Ste 103, Hattiesburg, MS 39402-3261 | 2011-03-30 |
| 1598947590 | Deborah T Anderson | Nurse Practitioner | 6101 U S Highway 49, Hattiesburg, MS 39401-7158 | 2007-11-30 |
| 1962628966 | Traci Davis Suber | Nurse Practitioner | 421 S 28th Ave Ste 200, Hattiesburg, MS 39401-7208 | 2007-04-18 |
| 1649380940 | Billy R Windham | Nurse Practitioner | 103 Tatum Park, Hattiesburg, MS 39401 | 2006-08-30 |
| 1528177540 | Neelou M. Patel | Nurse Practitioner | 34 Millbranch Rd Ste 80, Hattiesburg, MS 39402 | 2006-08-30 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
Please comment or provide details below to improve the information on HOLLY KAYLENE ODOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.