Provider Demographics
NPI:1003033598
Name:WRZESINSKI, JUDITH CAROL (CNM)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:CAROL
Last Name:WRZESINSKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SNELSON DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-7416
Mailing Address - Country:US
Mailing Address - Phone:828-515-5227
Mailing Address - Fax:828-515-5227
Practice Address - Street 1:24 SNELSON DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-515-5227
Practice Address - Fax:828-515-5227
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC286113163W00000X
NC634367A00000X
IL209.003484367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse