Provider Demographics
NPI:1063602720
Name:HODAPP, CAREY D (BSN, RN, PHN)
Entity type:Individual
Prefix:
First Name:CAREY
Middle Name:D
Last Name:HODAPP
Suffix:
Gender:F
Credentials:BSN, RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 11TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3026
Mailing Address - Country:US
Mailing Address - Phone:320-444-7396
Mailing Address - Fax:
Practice Address - Street 1:805 11TH ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3026
Practice Address - Country:US
Practice Address - Phone:320-444-7396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR123458-7163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health