Jennifer Leeann Hudson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1194701516 Issued in OK

Practice address

4208 SE 24TH St
Del City, OK 73115-2529

Phone

(405) 219-9011

NPI assigned

Dec 7, 2021

Last updated

Dec 7, 2021By the provider in NPPES

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

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1790443794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 SE 24TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731152529",
            "telephone_number": "405-219-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 SE 24TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731152529",
            "telephone_number": "405-219-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JENNIFER",
        "middle_name": "LEEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": "1194701516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Hinton
• Chad Hobbs
• Shelli Holtsman
• Jessica Nell Howard Mack, DNP, APRN, FNP-C
• Paula Linae' Howard
• Autumn Hufford, COTA/L
• Iacc/Ehi NW, LLC (INTEGRIS Community Hospital - Del City)
• Steve Ihekona
• Impact Imaging, Inc.
• Kelsey Ingram, OTD

• Peer Specialist in Del City, OK
• Providers in Del City, OK by specialty
• Peer Specialist in Oklahoma

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