Provider Demographics
NPI:1073175337
Name:HUDSON, AUDREY LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:LYNN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E HAMPDEN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2518
Mailing Address - Country:US
Mailing Address - Phone:303-482-1300
Mailing Address - Fax:
Practice Address - Street 1:180 E HAMPDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2518
Practice Address - Country:US
Practice Address - Phone:303-482-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-07
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist