Healthcare Provider Details

I. General information

NPI: 1821798737
Provider Name (Legal Business Name): MS. APRIL EBONY HODGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 03/08/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 FOXDALE DR
JACKSONVILLE FL
32210-4637
US

IV. Provider business mailing address

11111 SAN JOSE BLVD STE 56
JACKSONVILLE FL
32223-7274
US

V. Phone/Fax

Practice location:
  • Phone: 904-718-3536
  • Fax:
Mailing address:
  • Phone: 904-465-7928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: