Provider Demographics
NPI:1447460290
Name:HUDSON, TOWYANNA MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TOWYANNA
Middle Name:MARIE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:TOWYANNA
Other - Middle Name:MARIE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2249 ROSE HILL DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2632
Mailing Address - Country:US
Mailing Address - Phone:419-870-1915
Mailing Address - Fax:
Practice Address - Street 1:2249 ROSEHILL DR.
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6529
Practice Address - Country:US
Practice Address - Phone:419-870-1915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH114306164W00000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home