Provider Demographics
NPI:1316235781
Name:HUDGINS, SHAWNTE L (DC)
Entity type:Individual
Prefix:DR
First Name:SHAWNTE
Middle Name:L
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16281
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-8281
Mailing Address - Country:US
Mailing Address - Phone:301-237-1213
Mailing Address - Fax:
Practice Address - Street 1:1423 POWHATAN ST STE 7
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1389
Practice Address - Country:US
Practice Address - Phone:703-739-7650
Practice Address - Fax:703-836-2667
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor