Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP7786 | AZ |
N | 363LA2200X | Nurse Practitioner - Adult Health | TAP7786 | AZ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 71000898A | IN |
NPI | 1003916990 |
---|---|
Provider Name | Ms. Judith Ann Abell |
First Address | Scottsdale, AZ 85251-4548 |
Second Address | Tempe, AZ 85284-1016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 20/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020928 | (05) | AZ |
28146869A | RN LICENSE (01) | IN |
71000898A | NURSE PRACTITIONER LICS. (01) | IN |
71000898B | CSR REFER. CARD (01) | IN |