Healthcare Provider Details

I. General information

NPI: 1578744371
Provider Name (Legal Business Name): JUDITH ARLENE YODER APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 WOODBURN RD
ANNANDALE VA
22003-1202
US

IV. Provider business mailing address

4111 25TH ST N
ARLINGTON VA
22207-3938
US

V. Phone/Fax

Practice location:
  • Phone: 703-289-2780
  • Fax:
Mailing address:
  • Phone: 703-999-6315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: