Healthcare Provider Details

I. General information

NPI: 1821950437
Provider Name (Legal Business Name): JESSICA ODELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 BURNETT DR STE 1
MOUNTAIN HOME AR
72653-2941
US

IV. Provider business mailing address

PO BOX 707
MOUNTAIN HOME AR
72654-0707
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-4200
  • Fax: 870-424-4327
Mailing address:
  • Phone: 870-424-7070
  • Fax: 870-424-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236815
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: