Provider Demographics
NPI:1518925932
Name:WASHINGTON, JUDY R (CRNP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:R
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:CRNP
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 5430
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36205-0430
Mailing Address - Country:US
Mailing Address - Phone:256-237-1624
Mailing Address - Fax:256-241-2277
Practice Address - Street 1:171 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205-4101
Practice Address - Country:US
Practice Address - Phone:256-237-1624
Practice Address - Fax:256-241-2277
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-048765207RC0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ46798Medicare UPIN