Kelly R Hudson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP60303592 Issued in WA

Practice address

805 Old Pioneer Way North
Ptarmigan Ridge
Orting, WA 98360

Phone

(360) 893-0595

Fax

(360) 893-0603

NPI assigned

Mar 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly R Bryant Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1588080097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WHITESELL ST",
            "address_2": "ORTING SCHOOL DISTRICT",
            "city": "ORTING",
            "state": "WA",
            "postal_code": "98360",
            "telephone_number": "360-893-6500",
            "fax_number": "360-893-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 OLD PIONEER WAY NORTH",
            "address_2": "PTARMIGAN RIDGE",
            "city": "ORTING",
            "state": "WA",
            "postal_code": "98360",
            "telephone_number": "360-893-0595",
            "fax_number": "360-893-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60303592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BRYANT",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in Orting, WA
• Providers in Orting, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.