Healthcare Provider Details

I. General information

NPI: 1740977438
Provider Name (Legal Business Name): THOMAS ADAM HUDSON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BALD HILL RD STE 506
WARWICK RI
02886-6111
US

IV. Provider business mailing address

400 BALD HILL RD STE 506
WARWICK RI
02886-6111
US

V. Phone/Fax

Practice location:
  • Phone: 844-700-3900
  • Fax:
Mailing address:
  • Phone: 844-700-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN03574
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: