Provider Demographics
NPI:1134176084
Name:HODGES, LAUREN KATHLEEN (CNM)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:KATHLEEN
Last Name:HODGES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520B WALTON RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6124
Mailing Address - Country:US
Mailing Address - Phone:732-241-5149
Mailing Address - Fax:
Practice Address - Street 1:2520B WALTON RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6124
Practice Address - Country:US
Practice Address - Phone:215-947-5545
Practice Address - Fax:215-947-8676
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010089367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife