Provider Demographics
NPI:1437500428
Name:HUDLIN, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HUDLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WHITTIER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7343
Mailing Address - Country:US
Mailing Address - Phone:413-822-2280
Mailing Address - Fax:
Practice Address - Street 1:37 CHESHIRE RD
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-1814
Practice Address - Country:US
Practice Address - Phone:413-443-4486
Practice Address - Fax:413-448-8279
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH18305183500000X
VT033.0003300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist