Individual
LISA H HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
4381 S EASON BLVD, SUITE 201, TUPELO, MS 38801-6583
(662) 377-5005
(662) 377-5301
Mailing address
4381 S EASON BLVD, SUITE 201, TUPELO, MS 38801-6583
(662) 377-5005
(662) 377-5301
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R819978
MS
Other
Enumeration date
02/10/2010
Last updated
03/21/2011
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