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General NPI Number Information
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NPI Number | 1902590144
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Entity Type | Individual
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Provider Name | KRISTI M HODGES
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Gender | Female
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 106 TORTOISE ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-8989
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Country | US
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Telephone | 828-231-7849
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Fax |
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Provider Business Mailing Address
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Address Line | 106 TORTOISE ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-8989
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Country | US
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Telephone | 828-231-7849
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Fax |
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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 | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 42459
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 138414
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License Number State | TN
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