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Individual

JACQUELINE COLEEN HUDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, MHS, BSN

Contact information

Practice address
1101 NW 178TH ST STE B, EDMOND, OK 73012-4281
(054) 285-2161
Mailing address
3001 TRAILHEAD DR, EDMOND, OK 73034-0831
(701) 340-4776

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2145
OK

Other

Enumeration date
11/22/2005
Last updated
05/29/2024
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