Provider Demographics
NPI:1306174859
Name:MENZIES, JUDEALYNE PERCY (BSN RN)
Entity type:Individual
Prefix:MRS
First Name:JUDEALYNE
Middle Name:PERCY
Last Name:MENZIES
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6651 CHIPPEWA ST STE 224
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2531
Mailing Address - Country:US
Mailing Address - Phone:314-645-6840
Mailing Address - Fax:314-645-6847
Practice Address - Street 1:6651 CHIPPEWA ST STE 224
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2531
Practice Address - Country:US
Practice Address - Phone:314-645-6840
Practice Address - Fax:314-645-6847
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO101992163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)