Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | G161038 | IA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | C160852 | IA |
NPI | 1013516566 |
---|---|
Provider Name | Mrs. Erin Ann Hodgson |
First Address | Sioux City, IA 51106-4736 |
Second Address | Sioux City, IA 51106-4736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2020 |
Last Update Date | 25/10/2020 |