Provider Demographics
NPI:1841544293
Name:HUDSON, ANGELA SHEPARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:SHEPARD
Last Name:HUDSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:423 YOPP RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3594
Mailing Address - Country:US
Mailing Address - Phone:910-347-9684
Mailing Address - Fax:910-455-0622
Practice Address - Street 1:423 YOPP RD
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3594
Practice Address - Country:US
Practice Address - Phone:910-347-9684
Practice Address - Fax:910-455-0622
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist