Provider Demographics
NPI:1205155140
Name:HUDKINS, JENNIFER (LPN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:HUDKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SISSON ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-1537
Mailing Address - Country:US
Mailing Address - Phone:860-906-8966
Mailing Address - Fax:
Practice Address - Street 1:63 SISSON ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1537
Practice Address - Country:US
Practice Address - Phone:860-906-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN85394164W00000X
CT031410164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse