Individual
JESSICA ANNE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
22250 PROVIDENCE DR, STE. 500, SOUTHFIELD, MI 48075-4825
(248) 849-3441
(248) 849-5386
Mailing address
22250 PROVIDENCE DR, STE. 500, SOUTHFIELD, MI 48075-4825
(248) 849-3441
(248) 849-5386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101024622
MI
390200000X
Student in an Organized Health Care Education/Training Program
5101022524
MI
Other
Enumeration date
06/22/2016
Last updated
05/15/2019
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