Provider Demographics
NPI:1437877412
Name:HUDSON, DAWN MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-8680
Mailing Address - Country:US
Mailing Address - Phone:765-265-0671
Mailing Address - Fax:
Practice Address - Street 1:541 BUTTERMILK PIKE
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1696
Practice Address - Country:US
Practice Address - Phone:859-212-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030207363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner