Organization
LUCY B HODGES RN FPNP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY B HODGES FPNP (NURSE PRACTITIONER)
(662) 299-2809
Entity
Organization
Contact information
Practice address
1303 RIVER RD, GREENWOOD, MS 38930-4029
(662) 299-2809
(662) 453-3581
Mailing address
1303 RIVER RD, GREENWOOD, MS 38930-4029
(662) 299-2809
(662) 453-3581
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
R537179
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07831008
—
MS
01
—
1023367455
NPI
MS
01
—
1639331994
NPI
MS
Enumeration date
08/30/2012
Last updated
04/03/2013
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