Individual
SUSAN ANN HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-0711
(410) 328-6896
Mailing address
PO BOX 62602, BALTIMORE, MD 21264-2602
(410) 328-0711
(410) 328-6896
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R072603
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063452852
—
DE
01
—
606686-01
BLUE CROSS/BLUE SHIELD
MD
05
—
964900000
—
MD
Enumeration date
06/08/2006
Last updated
03/07/2011
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