Healthcare Provider Details
I. General information
NPI: 1801149141
Provider Name (Legal Business Name): SHARONSHAY HUDSON RN, FNP PMHNP-BC DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/24/2012
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3380 BAYCHESTER AVE
BRONX NY
10475-1514
US
IV. Provider business mailing address
3380 BAYCHESTER AVE
BRONX NY
10475-1514
US
V. Phone/Fax
- Phone: 914-393-7947
- Fax:
- Phone: 914-393-7947
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | 80858 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 3285403 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 334605 |
| License Number State | NY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 471567 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: