Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Odom

Individual provider Certified Registered Nurse Anesthetist · NPI 1669216602

Nicole Odom is a Certified Registered Nurse Anesthetist (CRNA) in Philadelphia, Pennsylvania. Graduated from University of Utah School of Medicine in 2014, 12 years ago. Practices with Jefferson University Physicians, a 1,554-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
12
Trained at
University of Utah School of Medicine
Licensed in
PA
In the registry since
2024
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

111 S 11th St
Philadelphia, PA 19107-4870
Phone: (215) 955-6000
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN787676 (PA)

Record details

NPI number1669216602
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 24, 2024
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Jefferson University Physicians — 1554 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Philadelphia