Provider Demographics
NPI:1669696902
Name:HUDSON, NANCY PATRICIA (RN)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:PATRICIA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:PATRICIA
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:481 HICKORY HILL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4659
Mailing Address - Country:US
Mailing Address - Phone:803-750-0328
Mailing Address - Fax:
Practice Address - Street 1:1260 LEXINGTON DR
Practice Address - Street 2:DEPARTMENT OF NURSING
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-2176
Practice Address - Country:US
Practice Address - Phone:803-822-6758
Practice Address - Fax:803-822-3343
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17602163WH1000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WH1000XNursing Service ProvidersRegistered NurseHospice
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical