| NPI | 1992404636 |
|---|---|
| Former Name | KELLY HODGSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A173617) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186645) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-05-22 |