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NPI Code Detail

MEDICARE: JUDY WHARFF MHPP

MEDICARE: JUDY WHARFF MHPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1134423585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY WHARFF MHPP
Provider Business Mailing Address
First Line : 3352 N FUTRALL DR
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4057
Country : US
Telephone Number : 479-521-1427
Fax Number : 479-521-6520
Provider Business Practice Location Address
First Line : 121 SAW GRASSE POINT
Second Line :
City : HARRISON
State : AR
Zip : 72601-3072
Country : US
Telephone Number : 479-521-1427
Fax Number : 479-521-6520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2010
Last Update Date : 12/28/2010

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