Provider Demographics
NPI:1972982577
Name:HODGINS, SAMANTHA (NP)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:HODGINS
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 1:784 HERCULES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8049
Mailing Address - Country:US
Mailing Address - Phone:802-448-9784
Mailing Address - Fax:802-448-9784
Practice Address - Street 1:275 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2432
Practice Address - Country:US
Practice Address - Phone:866-476-1321
Practice Address - Fax:207-283-4408
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2291569363LW0102X, 163W00000X, 363LF0000X
MECNP241366363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1972982577Medicaid