Provider Demographics
NPI:1437857125
Name:JUDD, JESSICA JEAN (DNP-FNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEAN
Last Name:JUDD
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 S MEADOW WALK DR
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-2291
Mailing Address - Country:US
Mailing Address - Phone:435-671-2431
Mailing Address - Fax:
Practice Address - Street 1:998 E MILL RD
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-4590
Practice Address - Country:US
Practice Address - Phone:435-671-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT329568-4405363LP2300X
UT329568-3102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care