Healthcare Provider Details

I. General information

NPI: 1518615715
Provider Name (Legal Business Name): CARMEN ELIZABETH HUDSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W FM 700
BIG SPRING TX
79720-4120
US

IV. Provider business mailing address

4196 HIGHWAY 62 412 STE A
HARDY AR
72542-8002
US

V. Phone/Fax

Practice location:
  • Phone: 432-264-1900
  • Fax: 432-264-1901
Mailing address:
  • Phone: 870-856-1202
  • Fax: 432-264-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1073033
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1073033
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: