Provider Demographics
NPI:1588101307
Name:HUDNELL, BARBARA C (CFO,)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:HUDNELL
Suffix:
Gender:F
Credentials:CFO,
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:C
Other - Last Name:HUDNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CFTS
Mailing Address - Street 1:223 BUNGALOW DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8454
Mailing Address - Country:US
Mailing Address - Phone:252-945-2829
Mailing Address - Fax:252-633-0622
Practice Address - Street 1:223 BUNGALOW DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-8454
Practice Address - Country:US
Practice Address - Phone:252-945-2829
Practice Address - Fax:252-633-0622
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFO02654225000000X
NCCFTS0060225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795250Medicaid