Provider Demographics
NPI:1073141495
Name:HUMMEL, JUDITH (APNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18125 PRAIRIE FALCON LN
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-6316
Mailing Address - Country:US
Mailing Address - Phone:262-366-6237
Mailing Address - Fax:
Practice Address - Street 1:18125 PRAIRIE FALCON LN
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-6316
Practice Address - Country:US
Practice Address - Phone:262-366-6237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10012-33363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty