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General NPI Number Information
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NPI Number | 1841841459
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Entity Type | Individual
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Provider Name | KIERSTEN HUDSON
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Gender | Female
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 2040 BABCOCK RD STE 304
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4428
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Country | US
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Telephone | 210-731-9570
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Fax |
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Provider Business Mailing Address
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Address Line | 469 CENTINELA ST
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-5093
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Country | US
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Telephone | 682-232-6844
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 310510
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License Number State | TX
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