Provider Demographics
NPI:1003916990
Name:ABELL, JUDITH ANN (MS, NP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:ABELL
Suffix:
Gender:F
Credentials:MS, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7534 E 2ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4548
Mailing Address - Country:US
Mailing Address - Phone:480-607-3800
Mailing Address - Fax:480-607-3808
Practice Address - Street 1:1437 W AUTO DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1016
Practice Address - Country:US
Practice Address - Phone:602-362-2983
Practice Address - Fax:855-889-8024
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP7786363LA2200X
IN71000898A363LP2300X
AZAP7786363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020928Medicaid
IN71000898BOtherCSR REFER. CARD
IN28146869AOtherRN LICENSE
IN71000898AOtherNURSE PRACTITIONER LICS.