Individual
MRS. JACQUELINE DAVIS HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 726-8549
Mailing address
PO BOX 1337, MC 38, GALLUP, NM 87305-1337
(505) 726-8549
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
750608
CA
163W00000X
Registered Nurse
Primary
RN156433
AZ
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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