Individual
LAURA LYNN HUDSON-YEDVOBNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5405 MEMORIAL DR STE D, STONE MOUNTAIN, GA 30083-3236
(404) 296-3800
(404) 296-8753
Mailing address
5405 MEMORIAL DR STE D, STONE MOUNTAIN, GA 30083-3236
(404) 296-3800
(404) 296-8753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002474
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000148C
—
GA
Enumeration date
03/16/2007
Last updated
09/29/2011
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