Provider Demographics
NPI:1740426873
Name:ZDZIERA, JUDITH ANNE (MSHA, RN-BC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH ANNE
Middle Name:
Last Name:ZDZIERA
Suffix:
Gender:F
Credentials:MSHA, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N OXFORD VALLEY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2624
Mailing Address - Country:US
Mailing Address - Phone:215-547-5774
Mailing Address - Fax:
Practice Address - Street 1:333 N OXFORD VALLEY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2624
Practice Address - Country:US
Practice Address - Phone:215-547-5774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA48189191163WA2000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator