Individual
LILLIE C HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
760 BROOKWAY BLVD, BROOKHAVEN, MS 39601-2658
(601) 748-7270
Mailing address
760 BROOKWAY BLVD, BROOKHAVEN, MS 39601-2658
(601) 748-7270
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906956
MS
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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