Provider Demographics
NPI:1811249824
Name:HUDAK, VICTORIA R (CRNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:R
Last Name:HUDAK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:MCDONOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:929 PORTERS RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-9166
Mailing Address - Country:US
Mailing Address - Phone:717-634-9020
Mailing Address - Fax:
Practice Address - Street 1:2345 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2265
Practice Address - Country:US
Practice Address - Phone:410-329-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN527785L163W00000X
PASP012582363L00000X, 363LA2200X
PASP022867363LP0808X
MDR238419363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health