Provider Demographics
NPI:1679523401
Name:HUDGINS, PAULA ELIOSE (RNCS-BC)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ELIOSE
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:RNCS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MATTHEWS ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2910
Mailing Address - Country:US
Mailing Address - Phone:469-441-9440
Mailing Address - Fax:
Practice Address - Street 1:303 MATTHEWS ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2901
Practice Address - Country:US
Practice Address - Phone:469-441-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0236540101YA0400X
TX236540364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)