Provider Demographics
NPI:1437695293
Name:HODGES, LINDA GAIL (LPN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GAIL
Last Name:HODGES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:GAIL
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:167 BUCKHORN DR
Mailing Address - Street 2:
Mailing Address - City:KELLY
Mailing Address - State:LA
Mailing Address - Zip Code:71441-2017
Mailing Address - Country:US
Mailing Address - Phone:318-649-7250
Mailing Address - Fax:318-649-0149
Practice Address - Street 1:2513 FERRAND STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-649-2333
Practice Address - Fax:318-649-0149
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA900053251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health