MEDICARE: MEAGHAN ROSE HODGES BSN, RN, CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	5018688	NC

General Provider Information

NPI Number	:	1255007183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGHAN ROSE HODGES BSN, RN, CPNP-PC

Provider Business Mailing Address
First Line	:	400 LIBERTY HILL RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2446
Country	:	US
Telephone Number	:	910-739-3318
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 SOUTHERN AVE
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-3272
Country	:	US
Telephone Number	:	910-739-3318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	06/26/2024

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