Mary Elizabeth Odom

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN116176 Issued in AZ

Practice address

13500 N El Mirage Rd
El Mirage, AZ 85335-2469

Phone

(623) 876-7204

NPI assigned

Feb 27, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1922565829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 N EL MIRAGE RD",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853352469",
            "telephone_number": "623-876-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 N EL MIRAGE RD",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853352469",
            "telephone_number": "623-876-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN116176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huan Duy Nguyen, D.D.S.
• Nova Physician Group PLLC
• Armand C Ntwari, LAC
• Eucharia Nwabichie
• Reisha Oarde, DPM
• Jennifer Olague Carranza
• Candace B Ortiz
• Nicole Osofsky
• Brenda Patricia Palacios Zaragoza, MA
• Matthew Parrow, LCPC

• Registered Nurse in El Mirage, AZ
• Providers in El Mirage, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.