Provider Demographics
NPI:1538758982
Name:HUDSON, ASHLIE ALLYCE (CRNP)
Entity type:Individual
Prefix:MS
First Name:ASHLIE
Middle Name:ALLYCE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12815 HIGHWAY 278
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:AL
Mailing Address - Zip Code:35544-2954
Mailing Address - Country:US
Mailing Address - Phone:205-606-1200
Mailing Address - Fax:205-606-1202
Practice Address - Street 1:12815 HIGHWAY 278
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:AL
Practice Address - Zip Code:35544-2954
Practice Address - Country:US
Practice Address - Phone:205-606-1200
Practice Address - Fax:205-606-1202
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-126124207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL315394Medicaid