Provider Demographics
NPI:1578044459
Name:HODGES, VANESSA NATALIE (RN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:NATALIE
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 1:308 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-3026
Mailing Address - Country:US
Mailing Address - Phone:254-383-2944
Mailing Address - Fax:
Practice Address - Street 1:308 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528-3026
Practice Address - Country:US
Practice Address - Phone:254-383-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX925694163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics