# TIA B HUDON PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487107041
- **Authorized official:** TIA B HUDON FNP (OWNER)
- **Authorized official phone:** (702) 812-9613

## Contact information

- **Practice address:** 2225 E FLAMINGO RD STE 105, LAS VEGAS, NV 89119-5126
- **Practice address phone:** (702) 487-7055
- **Mailing address:** 180 W LONGACRES DR, HENDERSON, NV 89015-7914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2016
- **Last updated:** 09/27/2024