Provider Demographics
NPI:1003186719
Name:NANDWA, JUDITH KHALAMWA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:KHALAMWA
Last Name:NANDWA
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:3901 RAINBOW BLVD. 4070 DELP, MS 4017
Mailing Address - Street 2:KANSAS UNIVERSITY PHYSICIANS, INC.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-2501
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:3901 RAINBOW BLVD, 6040 DELP, MS 1020
Practice Address - Street 2:DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6005
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MO2009037503163W00000X
KS100732163W00000X
MO2012026433363LF0000X
KS75490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200869500AMedicaid
MO1003186719Medicaid
KS200869500AMedicaid
MO1003186719Medicaid
MOMA3347046Medicare PIN
KSP01126292Medicare PIN