Provider Demographics
NPI:1396337176
Name:HODGES, MARIA LOUISE (REGISTED NURSE)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LOUISE
Last Name:HODGES
Suffix:
Gender:F
Credentials:REGISTED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4802
Mailing Address - Country:US
Mailing Address - Phone:719-650-6444
Mailing Address - Fax:719-526-1172
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:719-526-8603
Practice Address - Fax:719-526-1172
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0107747163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management