Provider Demographics
NPI:1295187623
Name:CORDELL, JUDEE SARA MARIE (AGACNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:JUDEE
Middle Name:SARA MARIE
Last Name:CORDELL
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD, 4070 DELP, MS 4017
Mailing Address - Street 2:KANSAS UNIVERSITY PHYSICIANS, INC.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-2501
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:3901 RAINBOW BLVD, 6040 DELP, MS 1020
Practice Address - Street 2:DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6005
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77248-102363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care