MEDICARE: INGRID HODEN

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	207Q00000X	Family Medicine Physician	390200000X	FL
2	207Q00000X	Family Medicine Physician	18820	CA

General Provider Information

NPI Number	:	1376772467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID HODEN

Provider Business Mailing Address
First Line	:	4021 FLAMING PEAK CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-3687
Country	:	US
Telephone Number	:	702-701-1057
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 W BROOKS AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-3912
Country	:	US
Telephone Number	:	702-701-1057
Fax Number	:

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

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	08/27/2025

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Directions to “ INGRID HODEN ” Practice Location

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