Provider Demographics
NPI:1093447542
Name:THURSTON, JUDY ANNE (AUD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ANNE
Last Name:THURSTON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANNE
Other - Last Name:EGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:4912 SUN LAKE CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8852
Mailing Address - Country:US
Mailing Address - Phone:919-434-9999
Mailing Address - Fax:
Practice Address - Street 1:4912 SUN LAKE CT
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8852
Practice Address - Country:US
Practice Address - Phone:919-434-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003091-01231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist