Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | DO-02733 | IA |
NPI | 1003826181 |
---|---|
Provider Name | Dr. Barbara Hodne |
First Address | West Des Moines, IA 50266-9313 |
Second Address | Ankeny, IA 50023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5087791 | (05) | IA |
F45106 | (02) | IA |