Provider Demographics
NPI:1992973325
Name:HODSON, JOANNE CROWLEY (NP)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:CROWLEY
Last Name:HODSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:PATRICIA
Other - Last Name:HODSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1155 KELLY JOHNSON BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3932
Mailing Address - Country:US
Mailing Address - Phone:719-299-5990
Mailing Address - Fax:719-299-5992
Practice Address - Street 1:1155 KELLY JOHNSON BLVD
Practice Address - Street 2:STE 206
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3932
Practice Address - Country:US
Practice Address - Phone:719-299-5990
Practice Address - Fax:719-299-5992
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMHNP 5347363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0005347-NPOtherCOLORADO STATE BOARD