Active NPI
Detonya Hudson
- Registered Nurse
- El Mirage, AZ
National Provider Identifier
1225647456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN146961
- Practice address
- 12701 W Mandalay LN
El Mirage, AZ 85335-3415 - Phone
- (623) 703-5647
- NPI assigned
- Jul 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN146961 | AZ | Primary |
Addresses
Primary practice location
12701 W Mandalay LN
El Mirage, AZ 85335-3415
Mailing address
12701 W Mandalay LN
El Mirage, AZ 85335-3415
Phone (623) 703-5647
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://nppes.cms.hhs.gov |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN146961 | AZ | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1225647456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12701 W MANDALAY LN",
"city": "EL MIRAGE",
"state": "AZ",
"postal_code": "853353415",
"telephone_number": "623-703-5647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12701 W MANDALAY LN",
"city": "EL MIRAGE",
"state": "AZ",
"postal_code": "853353415",
"telephone_number": "623-703-5647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "DETONYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "RN146961",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://nppes.cms.hhs.gov",
"affiliation": "N",
"address_1": "12701 W Mandalay Ln",
"city": "El Mirage",
"state": "AZ",
"country_code": "US",
"postal_code": "853353415",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in El Mirage, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.