Individual ProviderLatania HudsonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3009 N Ballas Rd Ste 383c, Saint Louis, MO 63131-2324(314) 305-1447PECOS EnrollmentBased on the most recent information from CMS, provider Latania Hudson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174024350Provider TypeIndividualFull NameHudson, LataniaTitleMs.CredentialAPRN-BCGenderFemaleSole ProprietorNoEnumeration Date2/23/2018Last Updated12/10/2025Contact InformationPractice LocationPractice Address3009 N Ballas Rd Ste 383c, Saint Louis, MO 63131-2324Phone(314) 305-1447Fax(314) 996-4546Mailing LocationMailing AddressPO Box 959203, Saint Louis, MO 63195-9203Phone(314) 305-1447Fax(314) 996-4546Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2025025426MissouriCode363LA2200XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2025025426MissouriCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense2006025679MissouriProvider IdentifiersIDDescriptionIssuerIDXXXXXXXXXXDescriptionMedicaidIssuerUnlistedMissouri