Provider Demographics
NPI:1922885003
Name:HUDGENS, ANGELA (CO, CPED)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HUDGENS
Suffix:
Gender:F
Credentials:CO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4762 CAREA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-8969
Mailing Address - Country:US
Mailing Address - Phone:301-535-6070
Mailing Address - Fax:
Practice Address - Street 1:4762 CAREA RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-8969
Practice Address - Country:US
Practice Address - Phone:301-535-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD224L00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist