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General NPI Number Information
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NPI Number | 1558723270
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Entity Type | Individual
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Provider Name | CRYSTAL HUDSON NP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 105 GLEN OAK BLVD SUITE 200
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6424
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Country | US
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Telephone | 615-822-6716
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Fax | 615-822-9805
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Provider Business Mailing Address
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Address Line | 120 POPLAR GROVE RD
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City | WESTMORELAND
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State | TN
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Zip | 37186-2520
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Country | US
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Telephone | 615-572-4287
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Fax |
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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 | 20986
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License Number State | TN
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