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Individual

MRS. JACQUELINE ANTOINETTE HUDAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
298 MEMORIAL DR, SENECA, SC 29672-9443
(864) 885-7758
(864) 885-7749
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19302
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP3182
SC
Enumeration date
01/27/2015
Last updated
06/30/2021
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