Provider Demographics
NPI:1144096298
Name:HUDGINS, LATRICE DARNELLA
Entity type:Individual
Prefix:
First Name:LATRICE
Middle Name:DARNELLA
Last Name:HUDGINS
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 1:122 W END HTS APT 604
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2533
Mailing Address - Country:US
Mailing Address - Phone:615-486-8613
Mailing Address - Fax:
Practice Address - Street 1:122 W END HTS APT 604
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2533
Practice Address - Country:US
Practice Address - Phone:615-486-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health