Hodge, Jillian A

Hodge, Jillian A is an individual health care provider with primary practice located at 22361 Oak Ridge Dr , Shell Knob MO 65747-7822. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Hodge, Jillian A can be contacted via phone (417) 858-3731.

Contact Information

Primary practice address
22361 Oak Ridge Dr Shell Knob MO 65747-7822
Phone: (417) 858-3731
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 2004036967 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2017021980 Missouri

Profile Details

NPI number 1194254664
LBN Legal business name Hodge, Jillian A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2017
Last updated Jul 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194254664 NPPES
Missouri MEDICAID PENDING

Popular Providers