Martha Hodge, RN
Individual provider Active NPI Registered Nurse · Fairfield, IL
NPI 1124449095 · NPPES record last updated Dec 19, 2013
Key facts
- NPI
- 1124449095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 041283137 (IL)
- Practice address
- 209 NW 11TH St
Fairfield, IL 62837-1218 - Phone
- (618) 724-2401
- NPI assigned
- Dec 19, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041283137 | IL | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041283137 | IL | Yes |
Addresses
Primary practice location
209 NW 11TH St
Fairfield, IL 62837-1218
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401
Other providers in Fairfield, IL
- Kathy Hatton
- Deana Lynne Hawkins
- Ross Herdes
- Highland Park CVS, L.L.C.
- Kathie L Hill
- Jacob Lonnie Holmes
- Jakara Hopper
- Irina Podolsky PSYD LLC
- Jasper C.C.S.D. 17
- Linda Sue Jennette
All providers in Fairfield, IL · Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.