Provider Demographics
NPI:1750457024
Name:ODHAM, PATRICIA A (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:ODHAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7353
Mailing Address - Country:US
Mailing Address - Phone:910-970-4673
Mailing Address - Fax:910-970-4670
Practice Address - Street 1:3121 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4111
Practice Address - Country:US
Practice Address - Phone:910-769-6053
Practice Address - Fax:910-769-9048
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5001162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily