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General NPI Number Information
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NPI Number | 1851236111
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Entity Type | Individual
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Provider Name | JEREMY HUDSON RN
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Gender | Male
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 10864 TEXAS HEALTH TRL
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City | FORT WORTH
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State | TX
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Zip | 76244-4897
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Country | US
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Telephone | 682-212-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 13100 LARKS VIEW PT
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City | FORT WORTH
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State | TX
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Zip | 76244-1818
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Country | US
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Telephone |
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 839595
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License Number State | TX
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