MEDICARE: VIRGINIA HUDSON FNP

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
1	363LF0000X	Family Nurse Practitioner	RN064157	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689622946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA HUDSON FNP

Provider Business Mailing Address
First Line	:	3939 WHITE HOUSE PKWY
Second Line	:
City	:	WARM SPRINGS
State	:	GA
Zip	:	31830-2455
Country	:	US
Telephone Number	:	706-655-4088
Fax Number	:	706-655-4091

Provider Business Practice Location Address
First Line	:	3939 WHITE HOUSE PKWY
Second Line	:
City	:	WARM SPRINGS
State	:	GA
Zip	:	31830-2455
Country	:	US
Telephone Number	:	706-655-4088
Fax Number	:	706-655-4091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	09/22/2016

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Directions to “ VIRGINIA HUDSON FNP” Practice Location

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