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General NPI Number Information
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NPI Number | 1194178376
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Entity Type | Individual
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Provider Name | AMY HODGES APRN, CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 172 HIGHWAY 62 W
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City | SALEM
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State | AR
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Zip | 72576-8059
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Country | US
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Telephone | 870-895-2735
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Fax | 870-895-2709
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Provider Business Mailing Address
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Address Line | PO BOX 83
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City | CORNING
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State | AR
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Zip | 72422-0083
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Country | US
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Telephone | 870-857-3334
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Fax | 870-857-9934
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A004837
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License Number State | AR
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