Provider Demographics
NPI:1023580487
Name:HUDSON, AMY (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 SCOTTSVILLE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4400
Mailing Address - Country:US
Mailing Address - Phone:270-746-6330
Mailing Address - Fax:
Practice Address - Street 1:2508 SCOTTSVILLE RD STE 104
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4400
Practice Address - Country:US
Practice Address - Phone:270-746-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1101384163W00000X
KY3013013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse