Provider Demographics
NPI:1083832091
Name:HODGES, URSULA ALEXCIA (RN)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:ALEXCIA
Last Name:HODGES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 BROCK BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2473
Mailing Address - Country:US
Mailing Address - Phone:301-498-6280
Mailing Address - Fax:
Practice Address - Street 1:405 BROCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2473
Practice Address - Country:US
Practice Address - Phone:301-498-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR168797163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool