Individual
MS. KELLY A HUDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1605 N CEDAR CREST BLVD STE 110B, ALLENTOWN, PA 18104-2351
(610) 973-1410
(610) 973-1442
Mailing address
1605 N CEDAR CREST BLVD STE 110B, ALLENTOWN, PA 18104-2351
(610) 973-1410
(610) 973-1442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
NN095449NJ
NJ
207Q00000X
Family Medicine Physician
VP006579B
PA
363LF0000X
Family Nurse Practitioner
Primary
VP006579B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223733353
HORIZON
NJ
01
—
2318736
AETNA
NJ
05
—
8440506
—
NJ
Enumeration date
05/01/2006
Last updated
12/14/2021
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