Provider Demographics
NPI:1497750509
Name:HODSON, DEANNA SIMONCELLI (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:SIMONCELLI
Last Name:HODSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 HWY 308
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70373-2056
Mailing Address - Country:US
Mailing Address - Phone:985-798-7000
Mailing Address - Fax:985-798-7021
Practice Address - Street 1:13030 HIGHWAY 308
Practice Address - Street 2:
Practice Address - City:LAROSE
Practice Address - State:LA
Practice Address - Zip Code:70373-2001
Practice Address - Country:US
Practice Address - Phone:985-798-7000
Practice Address - Fax:985-798-7021
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02816363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1532312Medicaid
LA1532312Medicaid
LAS50887Medicare UPIN