Provider Demographics
NPI:1477859684
Name:HUDSON, ROBIN PRINCE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:PRINCE
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 1:418 HIGHLAND PARK
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2916
Mailing Address - Country:US
Mailing Address - Phone:931-735-2301
Mailing Address - Fax:
Practice Address - Street 1:418 HIGHLAND PARK
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2916
Practice Address - Country:US
Practice Address - Phone:931-735-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN64026164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse