Provider Demographics
NPI:1679145999
Name:HODGE, HANNAH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HODGE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:HODGE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:KY
Mailing Address - Zip Code:42217-0052
Mailing Address - Country:US
Mailing Address - Phone:270-484-6949
Mailing Address - Fax:
Practice Address - Street 1:270 WALTON WAY
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-6808
Practice Address - Country:US
Practice Address - Phone:270-886-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1152269163WP0808X
KY3016865363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health