Odom, Courtney Chavis

Odom, Courtney Chavis is an individual health care provider with primary practice located at 3080 Highway 15-401 E , Mc Coll SC 29570-6128. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Odom, Courtney Chavis can be contacted via phone (843) 523-5751.

Contact Information

Primary practice address
3080 Highway 15-401 E Mc Coll SC 29570-6128
Phone: (843) 523-5751
Fax: (843) 523-6040
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 225769 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5015042 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 25309 South Carolina

Profile Details

NPI number 1962095612
LBN Legal business name Odom, Courtney Chavis
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2021
Last updated Mar 9th, 2023 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962095612 NPPES
South Carolina MEDICAID NP8401
South Carolina Other SCM901

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