Provider Demographics
NPI:1457933418
Name:ATWELL, JUDY (ND)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:ATWELL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 EMERALD WAY
Mailing Address - Street 2:
Mailing Address - City:CASTALIAN SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37031-4766
Mailing Address - Country:US
Mailing Address - Phone:615-720-2764
Mailing Address - Fax:
Practice Address - Street 1:109 CAMARADO LN
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4085
Practice Address - Country:US
Practice Address - Phone:615-720-2764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANP00000852175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath