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General NPI Number Information
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NPI Number | 1306204185
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Entity Type | Organization
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Legal Business Name | STEPHANIE LINVILLE HODGES PLLC
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 204 WESTWOOD SHOPPING CTR
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1528
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Country | US
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Telephone | 910-676-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 THORNGROVE CT
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-0259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE HODGES
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Credential | DNP, FNP-C
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Telephone | 910-584-0358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5006610
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 5006610
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License Number State | NC
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