Provider Demographics
NPI:1053915207
Name:HUDGIN, SHANNA E
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:E
Last Name:HUDGIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 DEVON DR
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-1945
Mailing Address - Country:US
Mailing Address - Phone:774-276-6008
Mailing Address - Fax:
Practice Address - Street 1:169 W MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-2175
Practice Address - Country:US
Practice Address - Phone:508-435-8184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist