Provider Demographics
NPI:1346228210
Name:JOLLETT, JUDITH C (NP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:C
Last Name:JOLLETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:J
Other - Last Name:SCHWEITZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10 CRAB CREEK LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-2521
Mailing Address - Country:US
Mailing Address - Phone:508-309-1991
Mailing Address - Fax:
Practice Address - Street 1:35 CEDAR ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3009
Practice Address - Country:US
Practice Address - Phone:508-778-6363
Practice Address - Fax:508-778-6677
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA118609363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANPO922Medicare ID - Type UnspecifiedBLUE CROSS BLUE SHIELD