Provider Demographics
NPI:1134008030
Name:HODGE, HANNAH (NP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HODGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 BRIGHT HTS W
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-6010
Mailing Address - Country:US
Mailing Address - Phone:901-833-2758
Mailing Address - Fax:
Practice Address - Street 1:1228 BRIGHT HTS W
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-6010
Practice Address - Country:US
Practice Address - Phone:901-833-2758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39577363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health