Healthcare Provider Details

I. General information

NPI: 1902768807
Provider Name (Legal Business Name): HUDSON NOELLE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ASHLEY RIDGE BLVD
SHREVEPORT LA
71106-7229
US

IV. Provider business mailing address

451 ASHLEY RIDGE BLVD
SHREVEPORT LA
71106-7229
US

V. Phone/Fax

Practice location:
  • Phone: 318-284-5550
  • Fax:
Mailing address:
  • Phone: 318-284-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2091-038AT
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: