Provider Demographics
NPI:1942196456
Name:HODGES, GINA (LPN)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 KINGSLEE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32409-3563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1923 KINGSLEE DR
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:FL
Practice Address - Zip Code:32409-3563
Practice Address - Country:US
Practice Address - Phone:850-624-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5230226164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse