MEDICARE: TABITHA LYNN HUDSON PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	116608-23	NH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.1000712-NP	CO

General Provider Information

NPI Number	:	1841099439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABITHA LYNN HUDSON PMHNP-BC

Provider Business Mailing Address
First Line	:	3720 SINTON RD STE 104
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-5085
Country	:	US
Telephone Number	:	719-493-9555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 N GRANT ST # 4513
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1859
Country	:	US
Telephone Number	:	303-656-9587
Fax Number	:	303-656-2138

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/03/2026

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