Provider Demographics
NPI:1508959677
Name:APPLEBY, JUDY A (CRNA)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:APPLEBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 SPANISH TRCE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2331
Mailing Address - Country:US
Mailing Address - Phone:785-794-2343
Mailing Address - Fax:
Practice Address - Street 1:420 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-7551
Practice Address - Country:US
Practice Address - Phone:402-463-9841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE108421367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NER32080Medicare UPIN
NE2701680Medicare ID - Type Unspecified
NEP00115603Medicare ID - Type UnspecifiedRR MEDICARE