Individual
CANDACE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10024 WATSON RD, SAINT LOUIS, MO 63126-1829
(314) 919-2500
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 364-7586
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
082961
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425900701
—
MO
Enumeration date
08/30/2006
Last updated
03/14/2023
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