Provider Demographics
NPI:1841274784
Name:MUNROE, JUDITH M (NP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:MUNROE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:451 ANDOVER ST
Mailing Address - Street 2:SUITE 335
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5044
Mailing Address - Country:US
Mailing Address - Phone:978-688-9979
Mailing Address - Fax:978-688-7727
Practice Address - Street 1:451 ANDOVER ST
Practice Address - Street 2:SUITE 335
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5044
Practice Address - Country:US
Practice Address - Phone:978-688-9979
Practice Address - Fax:978-688-7727
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MANP142731363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1512OtherBLUE SHIELD
MAS70186Medicare UPIN
MANP1512Medicare ID - Type Unspecified