Provider Demographics
NPI:1053144543
Name:HUDGINS, AMBER OAKES (PHARMD, CSP, CPP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:OAKES
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:PHARMD, CSP, CPP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MICHELLE
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2588 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1551 WESTBROOK PLAZA DR STE 200
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1355
Practice Address - Country:US
Practice Address - Phone:336-896-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7003831835P0018X
NC28921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SPCB002412OtherSPECIALTY PHARMACY CERTIFICATION BOARD