Individual
TIA B HUDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2225 E FLAMINGO RD STE 105, LAS VEGAS, NV 89119-5126
(702) 877-8625
Mailing address
180 W LONGACRES DR, HENDERSON, NV 89015-7914
(702) 487-7055
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APN000747
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500741
—
NV
01
—
P00091698
RAILROAD MEDICARE
NV
Enumeration date
02/27/2006
Last updated
11/01/2019
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