Provider Demographics
NPI:1568409191
Name:JUDICE, MARTHA ARAMBEL (FNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ARAMBEL
Last Name:JUDICE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 BISON LN
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3867
Mailing Address - Country:US
Mailing Address - Phone:406-727-4166
Mailing Address - Fax:
Practice Address - Street 1:805 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-1717
Practice Address - Country:US
Practice Address - Phone:406-455-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN26520363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000085424OtherCMS GROUP NUMBER
MT1184650855OtherGROUP NPI
MT0000372871OtherBCBS MT
MT000085424OtherCMS GROUP NUMBER