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General NPI Number Information
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NPI Number | 1497262372
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Entity Type | Individual
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Provider Name | TRACEY HUDSON
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Gender | Female
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Dates
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Enumeration Date | 01/02/2018
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 515 LOCUST AVE
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City | CONWAY
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State | AR
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Zip | 72034-5324
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Country | US
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Telephone | 501-327-5250
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Fax | 501-327-1464
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Provider Business Mailing Address
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Address Line | 515 LOCUST STREET 515 LOCUST STREET
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City | CONWAY
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State | AR
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Zip | 72034-5324
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Country | US
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Telephone | 501-327-5250
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Fax | 501-327-1464
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | A438
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A438
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License Number State | AR
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