Individual
JONELL RENAE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
601 W MAPLE AVE STE 102, SPRINGDALE, AR 72764-5370
(479) 750-6585
Mailing address
2427 WILLOW BEND CIR, SPRINGDALE, AR 72762-7443
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
8197
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21520406
NCBDE
—
01
—
302004876
BOARD OF PHARMACY SPECIALTIES
—
01
—
8197
BOARD OF PHARMACY
AR
Enumeration date
12/04/2020
Last updated
12/04/2020
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