Provider Demographics
NPI:1831314400
Name:HUDSON, SHERIA ANJANETTE (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:
First Name:SHERIA
Middle Name:ANJANETTE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 W 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2819
Mailing Address - Country:US
Mailing Address - Phone:302-655-0541
Mailing Address - Fax:302-654-7360
Practice Address - Street 1:1788 WILMINGTON PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342
Practice Address - Country:US
Practice Address - Phone:610-744-2960
Practice Address - Fax:610-744-2420
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000416174400000X
PASP009176363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No174400000XOther Service ProvidersSpecialist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily