Provider Demographics
NPI:1346744927
Name:HUDSON, SARA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:GAMBLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4914
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:2535 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-3124
Practice Address - Country:US
Practice Address - Phone:270-575-3001
Practice Address - Fax:270-575-0418
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily