Individual
LATICE HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
321 W 11TH ST, CHARLOTTE, NC 28202-0092
(704) 237-8793
Mailing address
4519 CANIPE DR, CHARLOTTE, NC 28269-5013
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
194321
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5016147
NC
Other
Enumeration date
12/22/2015
Last updated
05/02/2022
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