Provider Demographics
NPI:1891165932
Name:HUDSON, JEFFREY MARK (RN)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:MARK
Last Name:HUDSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18541 ROSE CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5912
Mailing Address - Country:US
Mailing Address - Phone:302-650-9815
Mailing Address - Fax:
Practice Address - Street 1:18541 ROSE CT
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-5912
Practice Address - Country:US
Practice Address - Phone:302-650-9815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0045346282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital