Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 26NN08141000 | NJ |
NPI | 1013246800 |
---|---|
Provider Name | Ms. Judith Lynn Bender |
First Address | Apo, AA 29207-5700 |
Second Address | Columbia, SC 29207-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2009 |
Last Update Date | 25/10/2016 |