Provider Demographics
NPI:1679641906
Name:HUDSON, ERICKA J (ARNP)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:J
Last Name:HUDSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:J
Other - Last Name:MONDOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1690 LUDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7603
Mailing Address - Country:US
Mailing Address - Phone:813-417-1117
Mailing Address - Fax:813-872-9191
Practice Address - Street 1:1812 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-5535
Practice Address - Country:US
Practice Address - Phone:727-943-0300
Practice Address - Fax:727-943-0339
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9196368363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9196368OtherLICENSE