Provider Demographics
NPI:1215162490
Name:HODGSON, CHRISTINE ROSE (PNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ROSE
Last Name:HODGSON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 W KAGY BLVD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6056
Mailing Address - Country:US
Mailing Address - Phone:406-522-5437
Mailing Address - Fax:
Practice Address - Street 1:280 W KAGY BLVD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6056
Practice Address - Country:US
Practice Address - Phone:406-522-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT29088363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics