Provider Demographics
NPI:1972982577
Name:HODGINS, SAMANTHA (NP)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:HODGINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 KNEELAND ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1901
Mailing Address - Country:US
Mailing Address - Phone:617-457-8140
Mailing Address - Fax:617-457-8141
Practice Address - Street 1:75 KNEELAND ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1901
Practice Address - Country:US
Practice Address - Phone:617-457-8140
Practice Address - Fax:617-457-8141
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2291569163W00000X, 363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health