Jordan, Mallory Odom
Jordan, Mallory Odom is an individual health care provider with primary practice located at 27 S Sixth St , Bay Springs MS 39422-9052. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jordan, Mallory Odom can be contacted via phone (601) 764-2155.Contact Information
Primary practice address
27 S Sixth St
Bay Springs MS 39422-9052
Phone: (601) 764-2155
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 904891 | Mississippi |
Profile Details
| NPI number | 1073285573 |
|---|---|
| LBN Legal business name | Jordan, Mallory Odom |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2021 |
| Last updated | Oct 2nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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