Individual
MS. LEA-ANA RAE HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
10345 WATSON ROAD, ST. LOUIS, MO 63127
(314) 384-3584
(314) 965-6067
Mailing address
10345 WATSON ROAD, ST. LOUIS, MO 63127
(314) 384-3584
(314) 965-6067
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2016041030
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420074643
—
MO
Enumeration date
11/17/2016
Last updated
12/06/2024
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