Provider Demographics
NPI:1245041995
Name:HUDSON, CELESTE JEANENE
Entity type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:JEANENE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41156
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23541-1156
Mailing Address - Country:US
Mailing Address - Phone:757-675-1791
Mailing Address - Fax:
Practice Address - Street 1:1548 BEEKMAN ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-1702
Practice Address - Country:US
Practice Address - Phone:757-675-1791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies