Andrea Corrine-Jacklyn Hudson, ATC, LAT

NPI #1942965926 in Temple, Texas

Provider Information

NPI Number: 1942965926
Entity Type: Individual
Name: Andrea Corrine-Jacklyn Hudson, ATC, LAT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: ATC, LAT
Enumeration Date: Nov 3, 2021
Last Updated: Mar 31, 2022

Practice Location

Address: 2401 S 31ST ST
City: Temple
State: Texas
ZIP Code: 76508-9603
Phone: (254) 724-2111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X
Physician Assistant	363A00000X	Primary

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