Provider Demographics
NPI:1114027273
Name:CUDWORTH, JUDITH NILSEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:NILSEN
Last Name:CUDWORTH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SUNSET CIR
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-9259
Mailing Address - Country:US
Mailing Address - Phone:252-338-4400
Mailing Address - Fax:
Practice Address - Street 1:711 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5643
Practice Address - Country:US
Practice Address - Phone:252-338-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11304363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics