Provider Demographics
NPI:1669678074
Name:DUPLESSIS, JUDY ANN (LVN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:DUPLESSIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 ADRIANA CT
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7043
Mailing Address - Country:US
Mailing Address - Phone:760-734-1876
Mailing Address - Fax:
Practice Address - Street 1:1252 WOODRAIL DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-3058
Practice Address - Country:US
Practice Address - Phone:760-758-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN196530164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARVN000650OtherMEDICAL PROVIDER NUMBER