Individual
PAMELA L. HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5330
Mailing address
1836 LACKLAND HILL PKWY, ATTN CREDENTIALING DEPARTMENT, SAINT LOUIS, MO 63146-3572
(313) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
047291
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00295577
RAILROAD MEDICARE
MO
Enumeration date
02/28/2007
Last updated
02/19/2008
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