Provider Demographics
NPI:1144764861
Name:HUDSON, JAZZLYN JACOLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JAZZLYN
Middle Name:JACOLE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JAZZLYN
Other - Middle Name:JACOLE
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2305 ORWELL ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3575
Mailing Address - Country:US
Mailing Address - Phone:931-446-6104
Mailing Address - Fax:
Practice Address - Street 1:328 FRONT ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4023
Practice Address - Country:US
Practice Address - Phone:888-852-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily