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General NPI Number Information
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NPI Number | 1700121332
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Entity Type | Individual
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Provider Name | CHRISTIAN MICHAEL JUDD DNP APRN
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Gender | Male
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Dates
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Enumeration Date | 12/08/2012
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 333 E MAIN ST UNIT 332
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City | LEHI
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State | UT
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Zip | 84043-4213
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Country | US
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Telephone | 801-550-3356
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Fax |
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Provider Business Mailing Address
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Address Line | 4460 S HIGHLAND DR STE 210
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-3550
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Country | US
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Telephone | 888-949-4864
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5254477-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 5254477-3102
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License Number State | UT
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