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NPI 1407867989

NPI 1407867989 : JACQUELINE TURNER ODUM CNP : SPARTANBURG, SC

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General NPI Number Information
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    NPI Number           |    1407867989
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    Entity Type          |    Individual 
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    Provider Name        |    JACQUELINE TURNER ODUM CNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/10/2006
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    Last Update Date     |    07/10/2025
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Provider Practice Location Address
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    Address Line         |    101 E WOOD ST 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29303-3040
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    Country              |    US
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    Telephone            |    864-560-1900
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    Fax                  |    864-560-1925
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Provider Business Mailing Address
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    Address Line         |    PO BOX 743070 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30374-3070
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    Country              |    US
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    Telephone            |    864-560-4304
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    Fax                  |    864-560-4413
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LW0102X
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    Taxonomy Name        |    Women's Health Nurse Practitioner
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    License Number       |    08103
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    363LW0102X
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    Taxonomy Name        |    Women's Health Nurse Practitioner
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    License Number       |    17565
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    License Number State |    SC
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