Provider Demographics
NPI:1235767005
Name:HUDNELL, STEPHANIE ALLISON (CNA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ALLISON
Last Name:HUDNELL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 ASHFORD BLVD APT 1004
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5647
Mailing Address - Country:US
Mailing Address - Phone:240-870-6055
Mailing Address - Fax:
Practice Address - Street 1:2245 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1206
Practice Address - Country:US
Practice Address - Phone:301-875-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00108371376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide