Provider Demographics
NPI:1700149937
Name:HODGES-RUST, SHARON (LM)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:HODGES-RUST
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6417 E FORDHAM DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-8754
Mailing Address - Country:US
Mailing Address - Phone:520-409-4877
Mailing Address - Fax:520-284-9297
Practice Address - Street 1:6417 E FORDHAM DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-8754
Practice Address - Country:US
Practice Address - Phone:520-409-4877
Practice Address - Fax:520-284-9297
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM171176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
13020001OtherCPM
AZ171OtherMIDWIFE LICENSE