MEDICARE: JUDY ANNE THURSTON AUD

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	231H00000X	Audiologist	003091-01	NY

General Provider Information

NPI Number	:	1093447542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY ANNE THURSTON AUD

Provider Business Mailing Address
First Line	:	4912 SUN LAKE CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8852
Country	:	US
Telephone Number	:	919-434-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	4912 SUN LAKE CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8852
Country	:	US
Telephone Number	:	919-434-9999
Fax Number	:

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

Provider Enumeration Date	:	06/24/2022
Last Update Date	:	01/27/2026

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