Provider Demographics
NPI:1770813867
Name:HUDSPATH, DAVID (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HUDSPATH
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:1601 MOTOR INN DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-2420
Mailing Address - Country:US
Mailing Address - Phone:724-824-4096
Mailing Address - Fax:724-269-9476
Practice Address - Street 1:2200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1357
Practice Address - Country:US
Practice Address - Phone:724-824-4096
Practice Address - Fax:724-269-9476
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2020-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PARN573676367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered