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MR. MICHAEL ALEXANDER HODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP, PMHNP,MSN

Contact information

Practice address
7282 BROOKE BLVD, REYNOLDSBURG, OH 43068-5274
(347) 451-2739
Mailing address
7282 BROOKE BLVD, REYNOLDSBURG, OH 43068-5274
(347) 451-2739

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.362463
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
025996
OH

Other

Enumeration date
08/19/2011
Last updated
11/26/2019
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