Individual
MRS. STACI LEA HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2705 HWY 51 SOUTH, HERNANDO, MS 38632
(662) 449-1971
Mailing address
2705 HWY 51 SOUTH, HERNANDO, MS 38632
(662) 449-1971
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
902167
MS
Other
Enumeration date
07/21/2017
Last updated
11/03/2019
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