Provider Demographics
NPI:1841481595
Name:WESSELY, JUDITH ELAINE (MSN,RN,CNS)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ELAINE
Last Name:WESSELY
Suffix:
Gender:F
Credentials:MSN,RN,CNS
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Mailing Address - Street 1:PO BOX 781633
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-1633
Mailing Address - Country:US
Mailing Address - Phone:210-508-6234
Mailing Address - Fax:210-916-1657
Practice Address - Street 1:27115 TRINITY HTS
Practice Address - Street 2:APT 1025
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2430
Practice Address - Country:US
Practice Address - Phone:210-508-6234
Practice Address - Fax:210-916-1657
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2016-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX222250364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS79143Medicare UPIN