MEDICARE: MS. SHAQUAN HUDSON HOME HEALTH AIDE

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	374U00000X	Home Health Aide
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1699022806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAQUAN HUDSON HOME HEALTH AIDE

Provider Business Mailing Address
First Line	:	3031 15TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4211
Country	:	US
Telephone Number	:	201-735-7303
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 15TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4211
Country	:	US
Telephone Number	:	201-735-7303
Fax Number	:

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

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	04/08/2025

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