Provider Demographics
NPI:1639614753
Name:HUDSON, KYMRY
Entity Type:Individual
Prefix:MISS
First Name:KYMRY
Middle Name:
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 1:653 E TULARE AVE APT A
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-3650
Mailing Address - Country:US
Mailing Address - Phone:559-308-0760
Mailing Address - Fax:559-625-3808
Practice Address - Street 1:320 W OAK AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4929
Practice Address - Country:US
Practice Address - Phone:559-625-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist