MEDICARE: LAUREN HUDSON NP-C

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	219776	GA

General Provider Information

NPI Number	:	1881046316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN HUDSON NP-C

Provider Business Mailing Address
First Line	:	3720 DAVINCI COURT
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30092
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 WARM SPRINGS RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-7932
Country	:	US
Telephone Number	:	706-304-8913
Fax Number	:

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

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	07/08/2016

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