MEDICARE: JUDITH ANN DELLARIPA RN, FNP-BC

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
1	363L00000X	Nurse Practitioner	0024168096	VA

General Provider Information

NPI Number	:	1972748135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH ANN DELLARIPA RN, FNP-BC

Provider Business Mailing Address
First Line	:	4121 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3317
Country	:	US
Telephone Number	:	804-213-0947
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3317
Country	:	US
Telephone Number	:	804-213-0947
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	05/15/2012

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