Provider Demographics
NPI:1699186635
Name:TESSIER, JUDITH MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MARIE
Last Name:TESSIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15100 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2901
Mailing Address - Country:US
Mailing Address - Phone:609-351-0242
Mailing Address - Fax:
Practice Address - Street 1:15100 N 90TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2901
Practice Address - Country:US
Practice Address - Phone:609-351-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist