Provider Demographics
NPI:1285407825
Name:HODGES, KAREN CHRISTINE (CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:HODGES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36258
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1204
Mailing Address - Country:US
Mailing Address - Phone:251-318-2678
Mailing Address - Fax:251-405-9900
Practice Address - Street 1:5100 RANGELINE SERVICE RD N # B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-9504
Practice Address - Country:US
Practice Address - Phone:251-661-4454
Practice Address - Fax:251-661-9843
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-163035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily