Doctor Name: | SUSAN FAY HODGE |
NPI Number: | 1609921865 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 0000084284 |
Business Practice Address: | 185 Justice Center Dr. Rutledge, TN - 37861 |
Business Phone Number: | 8658285247 |
Business Fax Number: | 8658283594 |
Mailing Address: | 637 Blackwell Branch Rd, RUTLEDGE |
State: | TN |
Postal Code: | 378615329 |
Phone Number: | 8652283663 |
Fax Number: | 8658283594 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 0000084284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |