Provider Demographics
NPI:1871263509
Name:HUDOKA, JESSICA ANNE (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:ANNE
Last Name:HUDOKA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1069
Mailing Address - Country:US
Mailing Address - Phone:267-629-9590
Mailing Address - Fax:
Practice Address - Street 1:1611 POND RD STE 400
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2258
Practice Address - Country:US
Practice Address - Phone:610-395-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024222363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics