Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 63033 | WI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 63033 | WI |
NPI | 1770927857 |
---|---|
Provider Name | Jasmine A Hudnall |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601-5429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 20/07/2017 |