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NPI Code Detail

MEDICARE: MRS. MARY LATINA HODGES FNP

MEDICARE: MRS. MARY LATINA HODGES FNP
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
1363LF0000XFamily Nurse PractitionerF12240885IA

General Provider Information

NPI Number : 1992518880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY LATINA HODGES FNP
Provider Business Mailing Address
First Line : 619 GREENFIELD ST NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-1315
Country : US
Telephone Number : 319-640-4304
Fax Number :
Provider Business Practice Location Address
First Line : 700 WAVERLY RD
Second Line :
City : DAVENPORT
State : IA
Zip : 52804-4317
Country : US
Telephone Number : 319-640-4304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2025
Last Update Date : 03/03/2026

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