Provider Demographics
NPI:1134271281
Name:JONES, JUDITH WOMACK (ARNP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:WOMACK
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:WOMACK
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:52 S VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35961-3263
Mailing Address - Country:US
Mailing Address - Phone:256-524-3090
Mailing Address - Fax:
Practice Address - Street 1:52 S VALLEY AVE
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35961-3263
Practice Address - Country:US
Practice Address - Phone:850-602-4277
Practice Address - Fax:256-228-3506
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1667972363LG0600X
AL1-041207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE47164Medicare ID - Type UnspecifiedARNP