Provider Demographics
NPI:1467041368
Name:HUDSON, WRAYCHEL R
Entity Type:Individual
Prefix:
First Name:WRAYCHEL
Middle Name:R
Last Name:HUDSON
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 1:1505 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4942
Mailing Address - Country:US
Mailing Address - Phone:251-401-1955
Mailing Address - Fax:
Practice Address - Street 1:1505 KNOB HILL DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4942
Practice Address - Country:US
Practice Address - Phone:251-401-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program