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NPI Code Detail

MEDICARE: JENNIFER RENEE HUDSON PA(ASCP)

MEDICARE: JENNIFER RENEE HUDSON PA(ASCP)
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
1225500000XRespiratory/Developmental/Rehabilitative Specialist/Technologist

General Provider Information

NPI Number : 1407785165
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RENEE HUDSON PA(ASCP)
Provider Business Mailing Address
First Line : 7070 HOOVER DR
Second Line :
City : MENTOR
State : OH
Zip : 44060-4818
Country : US
Telephone Number : 586-918-0288
Fax Number :
Provider Business Practice Location Address
First Line : 10701 EAST BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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