Provider Demographics
NPI:1184707069
Name:HODGINS, CYNTHIA (APRN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HODGINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 VIVIAN DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1422
Mailing Address - Country:US
Mailing Address - Phone:512-246-2999
Mailing Address - Fax:
Practice Address - Street 1:301 HIGHWAY 71 W
Practice Address - Street 2:SUITE 110
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4105
Practice Address - Country:US
Practice Address - Phone:512-985-6082
Practice Address - Fax:512-985-6691
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602731363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
038144222OtherANCC CERTIFICATION NUMBER
TX00Y095Medicare PIN