Healthcare Provider Details

I. General information

NPI: 1386466456
Provider Name (Legal Business Name): JAMELA ANNETTE HODGSON CFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3606 N ELM ST STE F
GREENSBORO NC
27455-2603
US

IV. Provider business mailing address

3606 N ELM ST STE F
GREENSBORO NC
27455-2603
US

V. Phone/Fax

Practice location:
  • Phone: 336-708-0915
  • Fax: 336-271-4828
Mailing address:
  • Phone: 336-708-0915
  • Fax: 336-271-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: