Healthcare Provider Details

I. General information

NPI: 1770105942
Provider Name (Legal Business Name): HANNAH MORGAN HODGES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

IV. Provider business mailing address

1221 CONCORD AVE
BIRMINGHAM AL
35213-2120
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-6950
  • Fax: 205-975-3080
Mailing address:
  • Phone: 334-885-0049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number127468
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: