Provider Demographics
NPI:1568884955
Name:RACE, JUDITH A (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:RACE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 S YARROW ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2460
Mailing Address - Country:US
Mailing Address - Phone:303-989-5300
Mailing Address - Fax:
Practice Address - Street 1:2104 S YARROW ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2460
Practice Address - Country:US
Practice Address - Phone:303-989-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0125012163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse