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General NPI Number Information
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NPI Number | 1700562196
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Entity Type | Individual
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Provider Name | KASEY HUDNALL
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 3855 UPPER CREEK DR
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City | RUSKIN
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State | FL
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Zip | 33573-6814
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Country | US
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Telephone | 813-635-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 9914 BOSQUE CREEK CIR APT 302
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City | TAMPA
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State | FL
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Zip | 33619-5161
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Country | US
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Telephone | 402-430-2222
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40365
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License Number State | FL
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