Provider Demographics
NPI:1578045431
Name:HUDSON, SHERITTA LAVERNE (LVN)
Entity Type:Individual
Prefix:
First Name:SHERITTA
Middle Name:LAVERNE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10990 HIGHLAND MEADOW VLG DR APT 1106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5396
Mailing Address - Country:US
Mailing Address - Phone:832-362-6398
Mailing Address - Fax:
Practice Address - Street 1:10990 HIGHLAND MEADOW VLG DR APT 1106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-5396
Practice Address - Country:US
Practice Address - Phone:832-362-6398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321235164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse