Provider Demographics
NPI:1275066714
Name:HODGES, ERIN (NP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31515-2070
Mailing Address - Country:US
Mailing Address - Phone:912-367-9841
Mailing Address - Fax:912-367-7203
Practice Address - Street 1:3345 US HIGHWAY 84 STE 102
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-2160
Practice Address - Country:US
Practice Address - Phone:912-705-4910
Practice Address - Fax:912-705-4911
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204721363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health