MEDICARE: MRS. KATHLEEN C 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	363L00000X	Nurse Practitioner	LG-0001055	DE

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

General Provider Information

NPI Number	:	1881118420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN C HUDSON FNP

Provider Business Mailing Address
First Line	:	509 SEABURY AVE
Second Line	:
City	:	MILFORD
State	:	DE
Zip	:	19963-2216
Country	:	US
Telephone Number	:	302-382-8183
Fax Number	:

Provider Business Practice Location Address
First Line	:	35141 ATLANTIC AVE STE B
Second Line	:
City	:	MILLVILLE
State	:	DE
Zip	:	19967-6954
Country	:	US
Telephone Number	:	302-314-0774
Fax Number	:	302-364-1974

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

Provider Enumeration Date	:	07/26/2017
Last Update Date	:	04/04/2025

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