Individual
MISS NICHOLE HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 W HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Mailing address
1415 W HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3184
HEARING AID DISPENSER LICENSE
IL
Enumeration date
10/29/2014
Last updated
10/29/2014
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