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Contact Information

TRACY ODOM, CRNP
101 E PAULK AVE STE A
OPP, AL36467-1727
 Phone: 334-493-0311
 Fax: 334-493-0355
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family Health

364SF0001X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for TRACY ODOM · (Female)

NPI Number 1104332527
Status Active
Credentials CRNP (Certified Registered Nurse Practitioner)
Entity Individual
Enumeration date 12/21/2017
Last updated 04/04/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • AL License # 1-111973
  • AL Medicaid 305045
Hospital affiliation(s)
  • ANDALUSIA REGIONAL HOSPITAL - (Acute Care)
    849 SOUTH THREE NOTCH STREET
    ANDALUSIA, AL 36420
  • MIZELL MEMORIAL HOSPITAL - (Acute Care)
    702 N MAIN ST
    OPP, AL 36467
  • WIREGRASS MEDICAL CENTER - (Acute Care)
    1200 W MAPLE AVENUE
    GENEVA, AL 36340
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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