Provider Demographics
NPI:1295602670
Name:HUDSON, ANSLE SIFFORD (RD)
Entity type:Individual
Prefix:
First Name:ANSLE
Middle Name:SIFFORD
Last Name:HUDSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15633 OXYDENDRUM HILL RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8723
Mailing Address - Country:US
Mailing Address - Phone:704-904-0895
Mailing Address - Fax:
Practice Address - Street 1:15633 OXYDENDRUM HILL RD
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8723
Practice Address - Country:US
Practice Address - Phone:704-904-0895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000893133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered