Provider Demographics
NPI:1083929962
Name:HODLOFSKI, DIANA C (NP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:C
Last Name:HODLOFSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4003
Mailing Address - Country:US
Mailing Address - Phone:603-717-2699
Mailing Address - Fax:
Practice Address - Street 1:34 ATLANTIC PL STE 100
Practice Address - Street 2:
Practice Address - City:S PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2316
Practice Address - Country:US
Practice Address - Phone:225-407-9143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP241150364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health