Hodges, Stacey S

Hodges, Stacey S is an individual health care provider with primary practice located at 9 Physicians Dr , Jackson TN 38305. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Hodges, Stacey S can be contacted via phone (731) 661-0086.

Contact Information

Primary practice address
9 Physicians Dr Jackson TN 38305
Phone: (731) 661-0086
Fax: (731) 661-0281
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X RN105802 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN105802 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X APN 7203 Tennessee

Profile Details

NPI number 1104814805
LBN Legal business name Hodges, Stacey S
Credentials ACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104814805 NPPES
Tennessee MEDICAID 3902598

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