Provider Demographics
NPI:1861237745
Name:HUDSON, TOSHI B
Entity type:Individual
Prefix:
First Name:TOSHI
Middle Name:B
Last Name:HUDSON
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 1:18048 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:LAKE MILTON
Mailing Address - State:OH
Mailing Address - Zip Code:44429-9728
Mailing Address - Country:US
Mailing Address - Phone:330-506-8718
Mailing Address - Fax:
Practice Address - Street 1:18048 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:LAKE MILTON
Practice Address - State:OH
Practice Address - Zip Code:44429-9728
Practice Address - Country:US
Practice Address - Phone:330-506-8718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty