Healthcare Provider Details

I. General information

NPI: 1952113904
Provider Name (Legal Business Name): KRYSIA WARREN HUDSON DNP, MS, RN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N WOLFE ST # S412
BALTIMORE MD
21205-2110
US

IV. Provider business mailing address

525 N WOLFE ST # S412
BALTIMORE MD
21205-2110
US

V. Phone/Fax

Practice location:
  • Phone: 410-614-5313
  • Fax:
Mailing address:
  • Phone: 410-614-5313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberR097509
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: