Healthcare Provider Details

I. General information

NPI: 1023580487
Provider Name (Legal Business Name): AMY HUDSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2508 SCOTTSVILLE RD STE 104
BOWLING GREEN KY
42104-4400
US

IV. Provider business mailing address

5966 SCOTTSVILLE RD STE 3
BOWLING GREEN KY
42104-7908
US

V. Phone/Fax

Practice location:
  • Phone: 270-746-6330
  • Fax:
Mailing address:
  • Phone: 270-904-5104
  • Fax: 270-238-0333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3013013
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1101384
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013013
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: