Healthcare Provider Details

I. General information

NPI: 1346967288
Provider Name (Legal Business Name): MEGAN M HUDNALL B.S. E.D. , M.S. E.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN M DOODY

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5372 OLD VIRGINIA ST
URBANNA VA
23175-2179
US

IV. Provider business mailing address

5372 OLD VIRGINIA ST
URBANNA VA
23175-2179
US

V. Phone/Fax

Practice location:
  • Phone: 804-758-5250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberB201704998
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: