Provider Demographics
NPI:1376854091
Name:HUDSON, JESSICA ROSE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ROSE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2400 BELLEVUE RD
Mailing Address - Street 2:STE 21A
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2890
Mailing Address - Country:US
Mailing Address - Phone:478-328-0281
Mailing Address - Fax:478-328-0438
Practice Address - Street 1:230 N JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-3418
Practice Address - Country:US
Practice Address - Phone:478-453-8484
Practice Address - Fax:478-452-0987
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2019-12-17
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Provider Licenses
StateLicense IDTaxonomies
GARN157685363LX0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology