Individual provider · Type 1 NPI

Kellen Glyn Hodge, RN, CCM

Case Management Registered Nurse · Fort Polk, LA

NPI number 1891385787 Active

Practice location

1585 3rd St
Fort Polk, LA 71459-5102

Call (337) 531-3068 Map

Fax (337) 531-3428

Mailing address

215 Jett Rd
Hornbeck, LA 71439-1423

Specialties and licenses

TaxonomyCodeLicense
Case Management Registered Nurse Primary 163WC0400XRN115467 (LA)

Case Management Registered Nurse: Definition to come...

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About NPI 1891385787

Kellen Glyn Hodge, RN, CCM's National Provider Identifier is 1891385787, issued on Jan 25, 2021. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in Fort Polk, LA. The record was last updated on Jan 25, 2021.