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General NPI Number Information
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NPI Number | 1629686431
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Entity Type | Individual
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Provider Name | HANNAH RENAYE HUDGINS-MONTILLA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 515 W AQUARIUM PL STE 101
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City | JENKS
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State | OK
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Zip | 74037-6801
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Country | US
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Telephone | 918-740-4463
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Fax | 918-739-1601
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Provider Business Mailing Address
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Address Line | 11225 S 73RD EAST AVE
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City | BIXBY
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State | OK
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Zip | 74008-2167
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Country | US
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Telephone | 918-327-5894
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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 | R0096608
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License Number State | OK
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