Individual
MRS. JUDITH ANN HODITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1118 PASSOVER RD APT 110E, OSAGE BEACH, MO 65065-3619
(573) 382-1671
Mailing address
1118 PASSOVER RD APT 110E, OSAGE BEACH, MO 65065-3619
(573) 382-1671
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
119209
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0277464
ANCC
MO
01
—
119209
LICENSE
MO
01
—
12229102
CAQH ID
MO
01
—
1245361427
HIGH POINTE HEALTHCARE CLINIC NPI FOR RURAL HEALTH BILLING
MO
01
—
268933
MEDICARE TPAN
MO
05
—
428904817
—
MO
01
—
597361104
RURAL HEALTH CLINIC
MO
Enumeration date
12/20/2005
Last updated
11/17/2021
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