Provider Demographics
NPI:1386858272
Name:HUDSON, BEVERLY KAY (WHNP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:KAY
Last Name:HUDSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 LA ARRIBA DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6904
Mailing Address - Country:US
Mailing Address - Phone:912-321-9690
Mailing Address - Fax:
Practice Address - Street 1:11370 ANDERSON ST STE 3900
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3450
Practice Address - Country:US
Practice Address - Phone:909-558-2806
Practice Address - Fax:909-558-5077
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAPRN-NP074595363LW0102X
CA13209363LW0102X
TX459530363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health