Provider Demographics
NPI:1750643243
Name:HUDGINS, VICTORIA LEIGH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LEIGH
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:LEIGH
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 896199
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-4189
Mailing Address - Country:US
Mailing Address - Phone:833-936-1364
Mailing Address - Fax:605-942-7505
Practice Address - Street 1:738 BRYANT ST STE A
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4189
Practice Address - Country:US
Practice Address - Phone:704-873-5658
Practice Address - Fax:704-873-1116
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-03571363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant