Provider Demographics
NPI:1134661630
Name:HODNETT, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HODNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 MARLTON PIKE E
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2145
Mailing Address - Country:US
Mailing Address - Phone:856-424-6050
Mailing Address - Fax:856-424-2943
Practice Address - Street 1:1949 MARLTON PIKE E
Practice Address - Street 2:SUITE 1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2145
Practice Address - Country:US
Practice Address - Phone:856-424-6050
Practice Address - Fax:856-424-2943
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00667700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner