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General NPI Number Information
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NPI Number | 1629718374
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Entity Type | Individual
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Provider Name | RAVEN PARKER HODGES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1430 GADSDEN HWY STE 116-917
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3103
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Country | US
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Telephone | 208-623-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 17640 EASTMOOR ST
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City | ATHENS
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State | AL
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Zip | 35611-2175
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Country | US
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Telephone | 208-623-9050
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Fax | 480-900-8640
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 36482
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 894600
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1-172760
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 905241
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1170153
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License Number State | TX
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