Provider Demographics
NPI:1073567269
Name:HUDSON, LAURIE H (FNP-C)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:H
Last Name:HUDSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:R
Other - Last Name:HOUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6906
Mailing Address - Country:US
Mailing Address - Phone:540-662-1108
Mailing Address - Fax:
Practice Address - Street 1:400 CAMPUS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6906
Practice Address - Country:US
Practice Address - Phone:540-662-1108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA104336OtherRR MEDICARE
VA008749I71Medicare ID - Type Unspecified
VAA104336OtherRR MEDICARE