Provider Demographics
NPI:1518305788
Name:ANDERS, JUDITH ELAINE (PHD, MS, CNS, APRN)
Entity Type:Individual
Prefix:PROF
First Name:JUDITH
Middle Name:ELAINE
Last Name:ANDERS
Suffix:
Gender:F
Credentials:PHD, MS, CNS, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 TAHLEQUAH TRL
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6215
Mailing Address - Country:US
Mailing Address - Phone:972-492-4067
Mailing Address - Fax:
Practice Address - Street 1:1120 TAHLEQUAH TRL
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-6215
Practice Address - Country:US
Practice Address - Phone:972-492-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX564941163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology