Provider Demographics
NPI:1952632499
Name:HODGES, PRISCILLA NICOLA (LPN)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:NICOLA
Last Name:HODGES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1809
Mailing Address - Country:US
Mailing Address - Phone:914-777-3681
Mailing Address - Fax:
Practice Address - Street 1:138 GRAND ST
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1809
Practice Address - Country:US
Practice Address - Phone:914-777-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3000741164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse