Kirk Wayne Hudson | Bronx, NY • PECOS Search

Kirk Wayne Hudson

Registered Nurse

Nursing Service Providers

3482 Wilson Ave Apt 3b, Bronx, NY 10469-2312

PECOS Enrollment

Based on the most recent information from CMS, provider Kirk Wayne Hudson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1972171965
Provider Type
Individual
Full Name
Hudson, Kirk Wayne
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/15/2021
Last Updated
6/15/2021

Contact Information

Practice Location

3482 Wilson Ave Apt 3b, Bronx, NY 10469-2312

Unlisted Fax

Mailing Location

3482 Wilson Ave Apt 3b, Bronx, NY 10469-2312

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 803507 New York