Basic Information
Provider Information
NPI: 1407073109
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUDSON
FirstName: LAURA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 750 W US HIGHWAY 64
Address2:  
City: MURPHY
State: NC
PostalCode: 289068115
CountryCode: US
TelephoneNumber: 8288370071
FaxNumber: 8288375309
Practice Location
Address1: 91 TIMBERLANE RD
Address2:  
City: WAYNESVILLE
State: NC
PostalCode: 287867927
CountryCode: US
TelephoneNumber: 8284547220
FaxNumber: 8773461089
Other Information
ProviderEnumerationDate: 04/20/2007
LastUpdateDate: 12/21/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0809X5007029NCN Nursing Service ProvidersRegistered NursePsych/Mental Health, Adult
363LP0808X5007029NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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