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NPI Code Detail

MEDICARE: JUDY VANG

MEDICARE:   JUDY  VANG
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
13747P1801XPersonal Care AttendantMN

General Provider Information

NPI Number : 1245452952
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY VANG
Provider Business Mailing Address
First Line : 704 COTTAGE AVE E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-1709
Country : US
Telephone Number : 651-491-0100
Fax Number :
Provider Business Practice Location Address
First Line : 704 COTTAGE AVE E
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-1709
Country : US
Telephone Number : 651-491-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/08/2007

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Directions to “ JUDY VANG ” Practice Location

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