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PATRICIA K HODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
33602 N 25TH DR, PHOENIX, AZ 85085-6006
(480) 789-1668
Mailing address
33602 N 25TH DR, PHOENIX, AZ 85085-6006
(480) 789-1668

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP050113
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LP050113
HEALTH & FITNESS
AZ
Enumeration date
01/10/2019
Last updated
01/10/2019
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