Provider Demographics
NPI:1033200662
Name:ROSS, JUDY LEE (RN)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:LEE
Last Name:ROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:LEE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:JUDY LEE ROSS VETERANS AFFAIRS MEDICAL CTR
Mailing Address - Street 2:50 IRVING STREET NW, #116A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20422-0001
Mailing Address - Country:US
Mailing Address - Phone:202-745-8000
Mailing Address - Fax:202-745-8169
Practice Address - Street 1:JUDY LEE ROSS VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:50 IRVING STREET NW, #116A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:202-745-8169
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR030795163WA0400X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult