Provider Demographics
NPI:1306041330
Name:EDMUNDS, JUDY MARIE (CPM LDM)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:MARIE
Last Name:EDMUNDS
Suffix:
Gender:F
Credentials:CPM LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1014
Mailing Address - Street 2:
Mailing Address - City:YACHATS
Mailing Address - State:OR
Mailing Address - Zip Code:97498-1014
Mailing Address - Country:US
Mailing Address - Phone:541-547-4550
Mailing Address - Fax:
Practice Address - Street 1:949 YACHATS RIVER ROAD
Practice Address - Street 2:
Practice Address - City:YACHATS
Practice Address - State:OR
Practice Address - Zip Code:97498-1014
Practice Address - Country:US
Practice Address - Phone:541-547-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEMLD978121176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife