Provider Demographics
NPI:1023387495
Name:LUPO, JUDY (RN)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:LUPO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7295 JESSE BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:RURAL HALL
Mailing Address - State:NC
Mailing Address - Zip Code:27045-9528
Mailing Address - Country:US
Mailing Address - Phone:366-922-4424
Mailing Address - Fax:
Practice Address - Street 1:7295 JESSE BRIGGS RD
Practice Address - Street 2:
Practice Address - City:RURAL HALL
Practice Address - State:NC
Practice Address - Zip Code:27045-9528
Practice Address - Country:US
Practice Address - Phone:366-922-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC62313163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse