Provider Demographics
NPI:1568905081
Name:PAULL, JUDY CLAIRE (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:CLAIRE
Last Name:PAULL
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 STABLE GATE RD
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1059
Mailing Address - Country:US
Mailing Address - Phone:478-258-6378
Mailing Address - Fax:
Practice Address - Street 1:18 STABLE GATE RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1059
Practice Address - Country:US
Practice Address - Phone:478-258-6378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704104646364SP0809X
CA1267364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult