MEDICARE: MRS. LAMONICA ANTONETTE HODGES FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	242329	AZ
2	363LF0000X	Family Nurse Practitioner	GAA-NP002957	GA
3	363LF0000X	Family Nurse Practitioner	901388	MS
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-APN.0003375-C-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336504513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAMONICA ANTONETTE HODGES FNP-C

Provider Business Mailing Address
First Line	:	7204 E PARADISE DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-5433
Country	:	US
Telephone Number	:	480-613-6527
Fax Number	:	866-841-2587

Provider Business Practice Location Address
First Line	:	6040 N CAMELBACK MANOR DR
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-5148
Country	:	US
Telephone Number	:	784-532-9222
Fax Number	:	866-841-2587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	04/21/2026

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