MEDICARE: DONNA ANN HODGENS N.P.

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	363LP2300X	Primary Care Nurse Practitioner	26NR08692200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407855380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA ANN HODGENS N.P.

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD STE 220
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-5792
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 318
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-353-5600
Fax Number	:	845-353-3474

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	12/10/2024

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