Individual
MOLLIE T HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
78 N DIVISION ST, HESPERIA, MI 49421-5100
(231) 854-7235
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704200905
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4951590
—
MI
Enumeration date
08/08/2006
Last updated
12/07/2012
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