Individual
MINDI HUDEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1700 E BARNETT RD, MEDFORD, OR 97504-0052
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
164W00000X
Licensed Practical Nurse
Primary
201130583LPN
OR
Other
Enumeration date
01/30/2019
Last updated
05/09/2019
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