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Individual

MRS. WANDA CHARLENE WALKER HODGES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1304 WIGEON CT, UPPER MARLBORO, MD 20774-7083
(301) 218-2195
Mailing address
1304 WIGEON CT, UPPER MARLBORO, MD 20774-7083
(301) 218-2195

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
752
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN0722
SC
Enumeration date
03/24/2006
Last updated
09/16/2011
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