Provider Demographics
NPI:1992194807
Name:HODES, MAEVE
Entity Type:Individual
Prefix:
First Name:MAEVE
Middle Name:
Last Name:HODES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MAEVE
Other - Middle Name:
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-8755
Mailing Address - Fax:
Practice Address - Street 1:110 NE SAINT LUKES BLVD
Practice Address - Street 2:STE 500
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6000
Practice Address - Country:US
Practice Address - Phone:816-932-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015001140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily