Provider Demographics
NPI:1700603420
Name:HUDSON, STACY J (APN)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:J
Last Name:HUDSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5 MYERS DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9517
Mailing Address - Country:US
Mailing Address - Phone:856-431-6300
Mailing Address - Fax:856-431-6310
Practice Address - Street 1:5 MYERS DR STE 105
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9517
Practice Address - Country:US
Practice Address - Phone:856-431-6300
Practice Address - Fax:856-431-6310
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15159600363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care