Provider Demographics
NPI:1740929231
Name:HUDSON, REBECCA MYNEKIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MYNEKIA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 W LOTHBURY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2881
Mailing Address - Country:US
Mailing Address - Phone:606-248-5322
Mailing Address - Fax:606-248-9244
Practice Address - Street 1:125 W LOTHBURY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2881
Practice Address - Country:US
Practice Address - Phone:606-248-5322
Practice Address - Fax:606-248-9244
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3017734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily