Provider Demographics
NPI:1962061101
Name:HODGES, MICHELE (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HODGES
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 1:5540 FALMOUTH ST STE 307
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1800
Mailing Address - Country:US
Mailing Address - Phone:804-288-1111
Mailing Address - Fax:804-288-1112
Practice Address - Street 1:5540 FALMOUTH ST STE 307
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1800
Practice Address - Country:US
Practice Address - Phone:804-288-1111
Practice Address - Fax:804-288-1112
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001325363LF0000X
VA0024185244363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology