Provider Demographics
NPI:1831393511
Name:WINT-MARTIN, JUDENE W (DNP, CRNP)
Entity type:Individual
Prefix:
First Name:JUDENE
Middle Name:W
Last Name:WINT-MARTIN
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:JUDENE
Other - Middle Name:W
Other - Last Name:WINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP
Mailing Address - Street 1:221 MILL WALK CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1565
Mailing Address - Country:US
Mailing Address - Phone:646-331-5771
Mailing Address - Fax:
Practice Address - Street 1:975 WESTTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5700
Practice Address - Country:US
Practice Address - Phone:610-399-7831
Practice Address - Fax:610-399-7810
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381602363LP0200X
AL1-154580363LP0200X
DELJ-0010412363LP0200X
PASPO25769363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY381602OtherN.P. LICENSE