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Laura Elizabeth Odom

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NPI Number Detailed Information

Provider Information:

Name: Laura Elizabeth Odom
Gender: F
Provider License Number If Given: RN142096

NPI Information:

NPI: 1295720720
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 4/9/2014

Provider Business Mailing Address:

Address: 6701 BAUM DR SUITE 140
Knoxville, TN 37919
Phone Number: 8655845727
Fax Number: 8654509904

Provider Business Practice Location Address:

Address: 801 N WEISGARBER RD SUITE 200
Knoxville, TN 37909
Phone Number: 8655848588
Fax Number: 8655843364

Provider Taxonomy:

Primary: 363L00000X
Secondary (if any): 363LF0000X
State: TN

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