Provider Demographics
NPI:1003916990
Name:ABELL, JUDITH ANN (MS, NP-BC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:ABELL
Suffix:
Gender:F
Credentials:MS, NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 W ROYAL OAK RD APT R
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3168
Mailing Address - Country:US
Mailing Address - Phone:801-273-0001
Mailing Address - Fax:
Practice Address - Street 1:10010 W ROYAL OAK RD APT R
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3168
Practice Address - Country:US
Practice Address - Phone:801-273-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN040573163WH0200X, 163WW0000X
AZAP7786363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP7786OtherNP LICENSE
AZ020928Medicaid
AZRN040573OtherRN
IN71000898AOtherNURSE PRACTITIONER LICS.