Provider Demographics
NPI:1255579173
Name:VIOLETTE, JUDY ANN (RN,C)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:VIOLETTE
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036
Mailing Address - Country:US
Mailing Address - Phone:513-695-2717
Mailing Address - Fax:513-695-2737
Practice Address - Street 1:210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2009
Practice Address - Country:US
Practice Address - Phone:513-695-2717
Practice Address - Fax:513-695-2737
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN335047163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult