Individual
JADA ASHLEY HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E MIDDLE COUNTRY RD STE 310, SMITHTOWN, NY 11787-2814
(631) 265-1622
Mailing address
222 E MIDDLE COUNTRY RD STE 310, SMITHTOWN, NY 11787-2814
(631) 265-1622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
758871
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402989-01
NY
Other
Enumeration date
05/15/2020
Last updated
08/07/2020
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