Individual
REBEKAH M HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2001003687
MO
363AS0400X
Surgical Physician Assistant
Primary
2001003687
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111238
BLUE SHIELD/BLUE CHOICE
MO
01
—
627864
HEALTHLINK
MO
Enumeration date
05/18/2006
Last updated
09/12/2024
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