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General NPI Number Information
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NPI Number | 1154973345
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Entity Type | Individual
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Provider Name | ANGELA SETO HUDSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 501 MARSHALL ST STE 104
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City | JACKSON
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State | MS
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Zip | 39202-1663
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Country | US
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Telephone | 601-969-6404
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Fax | 601-973-4541
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Provider Business Mailing Address
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Address Line | 965 RIDGE LAKE BLVD STE 315
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City | MEMPHIS
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State | TN
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Zip | 38120-9401
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Country | US
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Telephone | 877-348-1281
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Fax | 901-227-3206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903419
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License Number State | MS
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