Provider Demographics
NPI:1407098692
Name:HUMMEL, JUDI ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JUDI
Middle Name:ANN
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:JUDI
Other - Middle Name:ANN
Other - Last Name:DAVIS-HUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5945 ETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-2814
Mailing Address - Country:US
Mailing Address - Phone:937-701-5990
Mailing Address - Fax:
Practice Address - Street 1:5945 ETHEL AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-2814
Practice Address - Country:US
Practice Address - Phone:937-701-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 068037 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2928523Medicaid