Provider Demographics
NPI:1366647166
Name:JUDD, DEBRA J (RN, ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:JUDD
Suffix:
Gender:F
Credentials:RN, ARNP
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 30507
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-3008
Mailing Address - Country:US
Mailing Address - Phone:509-747-7066
Mailing Address - Fax:509-838-3148
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:STE 104
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-747-7066
Practice Address - Fax:509-838-3148
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00064849364S00000X
WAAP60393686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily