Provider Demographics
NPI:1306484753
Name:HODGES, ASHLEY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:HODGES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:482 W BOYCE ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-2626
Mailing Address - Country:US
Mailing Address - Phone:843-538-6240
Mailing Address - Fax:
Practice Address - Street 1:482 W BOYCE ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-2626
Practice Address - Country:US
Practice Address - Phone:843-538-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23357363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner