Jennifer Nicole Hudson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209017894 Issued in IL

Practice address

3732 Nameoki Rd
Granite City, IL 62040

Phone

(314) 221-0793

NPI assigned

Aug 18, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other names 1

• Jennifer Nicole White Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1336548155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 NAMEOKI RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "62040",
            "telephone_number": "314-221-0793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Emerald Ter",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262310",
            "country_code": "US",
            "telephone_number": "618-235-6780",
            "fax_number": "618-235-6740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Emerald Ter",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262310",
            "country_code": "US",
            "telephone_number": "618-235-6780",
            "fax_number": "618-235-6740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1604 Visa Dr",
            "address_2": "Ste. 1",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617612195",
            "country_code": "US",
            "telephone_number": "309-454-1100",
            "fax_number": "309-454-1107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "041.416814",
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020041195",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017894",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3732 Nameoki Rd",
            "city": "Granite City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhite335520@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jwhite335520@direct-ehr-ssmhc.com",
            "address_1": "3732 Nameoki Rd",
            "city": "Granite City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WHITE",
            "middle_name": "NICOLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiesha Hooks, CERTIFIED DOULA
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• Jowe Hsieh, MD
• Christina Marie Huckelberry, CCC-SLP
• Ellen D Huesgen, LCPC
• Robert Franklin Huey, DMD
• Stella Mae Huffman
• Roberta June Hughes, APN
• Sherry Ann Huskamp, LPN

• Nurse Practitioner in Granite City, IL
• Providers in Granite City, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.