Provider Demographics
NPI:1609215094
Name:HUDSON, ALICIA BOURASSA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:BOURASSA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W CROSS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2239
Mailing Address - Country:US
Mailing Address - Phone:033-972-7337
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2239
Practice Address - Country:US
Practice Address - Phone:303-233-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73977208000000X
CODR.0057152208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics