Provider Demographics
NPI:1790064046
Name:HODGES, ALISON S (ARNP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:S
Last Name:HODGES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 S VOLUSIA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7047
Mailing Address - Country:US
Mailing Address - Phone:386-383-3339
Mailing Address - Fax:212-340-0252
Practice Address - Street 1:108 W CITRUS ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2502
Practice Address - Country:US
Practice Address - Phone:386-218-6335
Practice Address - Fax:321-234-0252
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9284238363LF0000X
FLARNP 9284238363LA2200X
FL2023207276363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY08NTOtherBCBS
FLY08NTOtherBCBS