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Individual

MS. MARY D HUDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729
Mailing address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024171112
VA
363LF0000X
Family Nurse Practitioner
APO3981
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15864
LA
01
C06209
GROUP PTAN
VA
Enumeration date
02/12/2007
Last updated
12/10/2013
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