Provider Demographics
NPI:1124026943
Name:CHEN, JUDY T (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:T
Last Name:CHEN
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 10TH ST
Mailing Address - Street 2:WISHARD HEALTH SERVICES, MYERS W7555
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2859
Mailing Address - Country:US
Mailing Address - Phone:317-613-2315
Mailing Address - Fax:317-613-2316
Practice Address - Street 1:1001 W 10TH ST
Practice Address - Street 2:WISHARD HEALTH SERVICES, MYERS W7555
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2859
Practice Address - Country:US
Practice Address - Phone:317-613-2315
Practice Address - Fax:317-613-2316
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021295A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist