Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 10393 | NV |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 10393 | NV |
NPI | 1386615672 |
---|---|
Provider Name | Dr. Stacey Allen Finley Hudson |
First Address | Reno, NV 89521-8977 |
Second Address | Reno, NV 89521-8977 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 17/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100500145 | (05) | NV |
G96995 | (02) |