# ANDREA CORRINE-JACKLYN HUDSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1942965926
- **Gender:** F
- **Credential:** ATC, LAT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2255A2300X | Athletic Trainer | AT8127 | TX | — |
| 363A00000X | Physician Assistant | PA15474 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 11/03/2021
- **Last updated:** 03/31/2022