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NPI Code Detail

MEDICARE: MR. DERRICK D HUDSON RN

MEDICARE: MR. DERRICK D HUDSON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR085961AR

General Provider Information

NPI Number : 1023950748
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DERRICK D HUDSON RN
Provider Business Mailing Address
First Line : 2601 MCCAIN BLVD STE C
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8013
Country : US
Telephone Number : 501-604-6604
Fax Number : 501-451-5644
Provider Business Practice Location Address
First Line : 2601 MCCAIN BLVD STE C
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8013
Country : US
Telephone Number : 501-604-6604
Fax Number : 501-451-5644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ MR. DERRICK D HUDSON RN” Practice Location

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