| NPI | 1477197705 |
|---|---|
| Former Name | KELSEY-JO AUDREY HODGES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201907307NP-PP) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |