Provider Demographics
NPI:1720472087
Name:HOCHKINS, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HOCHKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MOUNTAINSIDE VILLAGE PKWY
Mailing Address - Street 2:BUILDING 500
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-8694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 MOUNTAINSIDE VILLAGE PKWY
Practice Address - Street 2:BUILDING 500
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-8694
Practice Address - Country:US
Practice Address - Phone:706-253-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220322363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily