Basic Information
| Provider Information | |||||||||
| NPI: | 1871236455 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUDSON | ||||||||
| FirstName: | ANNIE | ||||||||
| MiddleName: | KATE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 BELMONT BLVD APT 301 | ||||||||
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| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372124509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154182752 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2025 N MOUNT JULIET RD STE 130 | ||||||||
| Address2: | |||||||||
| City: | MT JULIET | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371223994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158850200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2022 | ||||||||
| LastUpdateDate: | 04/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 12665514 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.