Provider Demographics
NPI:1487128153
Name:HUDSON, HETTY KAREN (NP)
Entity type:Individual
Prefix:
First Name:HETTY
Middle Name:KAREN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HETTY
Other - Middle Name:KAREN
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6620 MCGINNIS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1542
Mailing Address - Country:US
Mailing Address - Phone:678-695-6747
Mailing Address - Fax:770-573-6004
Practice Address - Street 1:6620 MCGINNIS FERRY RD
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1542
Practice Address - Country:US
Practice Address - Phone:678-695-6747
Practice Address - Fax:770-573-6004
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220879363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care