Provider Demographics
NPI:1053189191
Name:HODGE, CALLIE ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:ELIZABETH
Last Name:HODGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11696 S LAUREL DR APT 3C
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3040
Mailing Address - Country:US
Mailing Address - Phone:240-351-8611
Mailing Address - Fax:
Practice Address - Street 1:11696 S LAUREL DR APT 3C
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3040
Practice Address - Country:US
Practice Address - Phone:240-351-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula