Provider Demographics
NPI:1679031926
Name:FRATES, JUDY RUTH (RN)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:RUTH
Last Name:FRATES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20271 TALON POINT CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5604
Mailing Address - Country:US
Mailing Address - Phone:757-289-5827
Mailing Address - Fax:
Practice Address - Street 1:20271 TALON POINT CT
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23803-5604
Practice Address - Country:US
Practice Address - Phone:757-289-5827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001156256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse