Provider Demographics
NPI:1740687722
Name:HUDSON, INGER PERNILLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:INGER
Middle Name:PERNILLE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:INGER
Other - Middle Name:PERNILLW
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:400 N. PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424
Mailing Address - Country:US
Mailing Address - Phone:970-547-9343
Mailing Address - Fax:
Practice Address - Street 1:400 N. PARKWAY
Practice Address - Street 2:CITY MARKET PHARMACY
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424
Practice Address - Country:US
Practice Address - Phone:970-547-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist