MEDICARE: MS. JOANNE CROWLEY HODSON NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	MHNP 5347	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APN.0005347-NP	OTHER	CO	COLORADO STATE BOARD

General Provider Information

NPI Number	:	1992973325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNE CROWLEY HODSON NP

Provider Business Mailing Address
First Line	:	1155 KELLY JOHNSON BLVD
Second Line	:	STE 206
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3932
Country	:	US
Telephone Number	:	719-299-5990
Fax Number	:	719-299-5992

Provider Business Practice Location Address
First Line	:	1155 KELLY JOHNSON BLVD
Second Line	:	STE 206
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3932
Country	:	US
Telephone Number	:	719-299-5990
Fax Number	:	719-299-5992

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

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	08/28/2014

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