Healthcare Provider Details

I. General information

NPI: 1093493488
Provider Name (Legal Business Name): HANNAH AMA ODUM APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 KENNY RD FL 5
COLUMBUS OH
43210-3100
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-6196
  • Fax: 614-366-0073
Mailing address:
  • Phone: 614-293-6196
  • Fax: 614-366-0073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0034159
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0034159
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: