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Illisia Marie Hodge, NP-C
Family Nurse Practitioner in Laurel, Mississippi
NPI 1003486556

Illisia Marie Hodge is a Family Nurse Practitioner based in Laurel, MS and is specialized in Family. Illisia Marie Hodge practices in Laurel, MS and has the professional credentials of NP-C. The NPI Number for Illisia Marie Hodge is 1003486556 and holds a License No. F06212134 (Mississippi).

The current practice location address for Illisia Marie Hodge is 1008 N 15Th Ave, Laurel, MS and can be reached out via phone at 601-426-5125.

Location: 1008 N 15Th Ave, Laurel, MS, 39441-0247
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003486556
Provider Name
Illisia Marie Hodge
Credential
NP-C
Provider Entity Type
Individual
Gender
Female
Address
1008 N 15Th Ave, Laurel, MS, 39441-0247
Phone Number
601-426-5125
Fax Number
Provider Enumeration Date
06/28/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1008 N 15Th Ave
City
Laurel
State
Mississippi
Zip
39440-2656
Phone Number
601-426-5125
Fax Number
person
Provider Business Mailing Address Details
Address
1008 N 15Th Ave
City
Laurel
State
Mississippi
Zip
39440-2656
Phone Number
601-426-5125
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
F06212134 (Mississippi)
Definition
Definition to come...
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