Provider Demographics
NPI:1730991225
Name:HERNANDEZ-HUDSON, EUNICE
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:HERNANDEZ-HUDSON
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 1:9051 EXECUTIVE PARK DR STE 600
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4633
Mailing Address - Country:US
Mailing Address - Phone:865-474-0074
Mailing Address - Fax:
Practice Address - Street 1:9051 EXECUTIVE PARK DR STE 600
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4633
Practice Address - Country:US
Practice Address - Phone:865-474-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12098225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty