| Doctor Name: | HEATHER N HUDSON |
| NPI Number: | 1659701738 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 01705 |
| Business Practice Address: | 301 Great Teays Blvd Ste 6 Scott Depot, WV - 255609552 |
| Business Phone Number: | 3047576999 |
| Business Fax Number: | 3047606318 |
| Mailing Address: | 3415 Maccorkle Ave Se, CHARLESTON |
| State: | WV |
| Postal Code: | 253041334 |
| Phone Number: | 3047576999 |
| Fax Number: | 3042015019 |
| NPI Enumeration Date: | 11/26/2013 |
| NPI Last Update Date: | 03/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 01705 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |