Provider Demographics
NPI:1295302479
Name:HUDSON-MURRAY, COLLETTE
Entity type:Individual
Prefix:MRS
First Name:COLLETTE
Middle Name:
Last Name:HUDSON-MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COLLETTE
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:777 CLEVELAND AVE SW STE 506
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7115
Mailing Address - Country:US
Mailing Address - Phone:404-228-1568
Mailing Address - Fax:
Practice Address - Street 1:777 CLEVELAND AVE SW STE 506
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7115
Practice Address - Country:US
Practice Address - Phone:404-228-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN042581164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse