Provider Demographics
NPI:1386484731
Name:HUDSON, CLAUDETTE RUTH
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:RUTH
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8391
Mailing Address - Country:US
Mailing Address - Phone:570-239-3009
Mailing Address - Fax:
Practice Address - Street 1:45 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1912
Practice Address - Country:US
Practice Address - Phone:845-326-8015
Practice Address - Fax:845-326-8155
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY679904163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health