Healthcare Provider Details

I. General information

NPI: 1457481889
Provider Name (Legal Business Name): SHERRY M HUDSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HOSPITAL DR
CAMDEN TN
38320-1619
US

IV. Provider business mailing address

2206 FRENCH STORE RD
BIG SANDY TN
38221-5211
US

V. Phone/Fax

Practice location:
  • Phone: 731-584-4944
  • Fax:
Mailing address:
  • Phone: 731-584-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000038244
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: